Provider Demographics
NPI:1326545419
Name:MCCLAIN, LAUREN (CBE)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MCCLAIN
Suffix:
Gender:F
Credentials:CBE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12610 BRUNSWICK LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-2212
Mailing Address - Country:US
Mailing Address - Phone:301-464-0698
Mailing Address - Fax:
Practice Address - Street 1:3120 BELAIR DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-3101
Practice Address - Country:US
Practice Address - Phone:301-464-0698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-06
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator