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General NPI Number Information
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NPI Number | 1942797287
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Entity Type | Individual
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Provider Name | LAUREN MANK
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Gender | Female
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Dates
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Enumeration Date | 04/20/2018
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 12724 GRAN BAY PKWY W STE 410
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City | JACKSONVILLE
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State | FL
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Zip | 32258-9486
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Country | US
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Telephone | 855-382-6727
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Fax |
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Provider Business Mailing Address
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Address Line | 4530 ST JOHNS AVE STE 15 #177
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City | JACKONVILLE
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State | FL
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Zip | 32210
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Country | US
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Telephone | 803-225-6405
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106E00000X
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Taxonomy Name | Assistant Behavior Analyst
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License Number | 0-19-10612
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number |
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License Number State |
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