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NPI Code Detail

MEDICARE: CARA LYNN LAWRENCE

MEDICARE: CARA LYNN LAWRENCE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1134775687
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARA LYNN LAWRENCE
Provider Business Mailing Address
First Line : 1469 PALOMA DR
Second Line :
City : FORT MYERS
State : FL
Zip : 33901-6821
Country : US
Telephone Number : 239-280-8394
Fax Number :
Provider Business Practice Location Address
First Line : 3900 COLONIAL BLVD STE 1
Second Line :
City : FORT MYERS
State : FL
Zip : 33966-1014
Country : US
Telephone Number : 239-351-3715
Fax Number : 239-771-8732
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2019
Last Update Date : 08/12/2019

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Directions to “ CARA LYNN LAWRENCE ” Practice Location

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