Provider Demographics
NPI:1275021222
Name:KALTENBRUNNER, LENA
Entity type:Individual
Prefix:
First Name:LENA
Middle Name:
Last Name:KALTENBRUNNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1301 MUSEUM RD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-4739
Mailing Address - Country:US
Mailing Address - Phone:501-358-6535
Mailing Address - Fax:
Practice Address - Street 1:1301 MUSEUM RD
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-4739
Practice Address - Country:US
Practice Address - Phone:501-358-6535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-25
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Multi-Specialty
No103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Multi-Specialty
No106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst