MEDICARE: LAUREN MCDANIEL

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	171M00000X	Case Manager/Care Coordinator
2	106S00000X	Behavior Technician		AR

General Provider Information

NPI Number	:	1871907766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN MCDANIEL

Provider Business Mailing Address
First Line	:	250 STURGIS RD
Second Line	:
City	:	CONWAY
State	:	AR
Zip	:	72034-8334
Country	:	US
Telephone Number	:	501-513-7903
Fax Number	:	501-358-6264

Provider Business Practice Location Address
First Line	:	250 STURGIS RD
Second Line	:
City	:	CONWAY
State	:	AR
Zip	:	72034-8334
Country	:	US
Telephone Number	:	501-513-7903
Fax Number	:	501-358-6264

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

Provider Enumeration Date	:	06/18/2014
Last Update Date	:	07/18/2024

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Directions to “ LAUREN MCDANIEL ” Practice Location

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