Provider Demographics
NPI:1497019871
Name:FARIS, LAUREN FAYE (BA, CMII, BHRS)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:FAYE
Last Name:FARIS
Suffix:
Gender:F
Credentials:BA, CMII, BHRS
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:FARIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2403 S DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:GUTHRIE
Mailing Address - State:OK
Mailing Address - Zip Code:73044-6027
Mailing Address - Country:US
Mailing Address - Phone:405-260-3442
Mailing Address - Fax:405-260-3442
Practice Address - Street 1:2403 S DIVISION ST
Practice Address - Street 2:
Practice Address - City:GUTHRIE
Practice Address - State:OK
Practice Address - Zip Code:73044-6027
Practice Address - Country:US
Practice Address - Phone:405-260-3441
Practice Address - Fax:405-260-3442
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2014-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst