Provider Demographics
NPI:1851641591
Name:KATZ, LAUREN RACHEL (BCBA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:RACHEL
Last Name:KATZ
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3471 MAIN HWY
Mailing Address - Street 2:VILLA 727
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33133-5927
Mailing Address - Country:US
Mailing Address - Phone:917-645-6727
Mailing Address - Fax:
Practice Address - Street 1:8001 SW 36TH ST
Practice Address - Street 2:SUITE 9
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33328-1915
Practice Address - Country:US
Practice Address - Phone:954-577-7790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY856666174400000X
NY1-09-5193103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No174400000XOther Service ProvidersSpecialist