Healthcare Provider Details

I. General information

NPI: 1932536398
Provider Name (Legal Business Name): LAUREN ELIZABETH ROTHSTEIN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAUREN ELIZABETH MANN ED.M.

II. Dates (important events)

Enumeration Date: 10/01/2013
Last Update Date: 12/09/2020
Certification Date: 12/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 ALMA DR
PLANO TX
75075-6937
US

IV. Provider business mailing address

1700 ALMA DR
PLANO TX
75075-6937
US

V. Phone/Fax

Practice location:
  • Phone: 469-344-1414
  • Fax:
Mailing address:
  • Phone: 469-344-1414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: