MEDICARE: LAUREN MALIK CANADY

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
1	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1326612821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN MALIK CANADY

Provider Business Mailing Address
First Line	:	207 SKYVIEW DR
Second Line	:
City	:	CLEMSON
State	:	SC
Zip	:	29631-1737
Country	:	US
Telephone Number	:	985-320-2999
Fax Number	:

Provider Business Practice Location Address
First Line	:	9305 MAIN ST
Second Line	:
City	:	ZACHARY
State	:	LA
Zip	:	70791-7441
Country	:	US
Telephone Number	:	225-278-1020
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2021
Last Update Date	:	06/18/2026

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Directions to “ LAUREN MALIK CANADY ” Practice Location

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