Provider Demographics
NPI:1942797675
Name:BEATTIE, LAUREN (RBT, BCBA)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:BEATTIE
Suffix:
Gender:F
Credentials:RBT, BCBA
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:ANNE
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1771 E FLAMINGO RD STE 220A
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89119-0850
Mailing Address - Country:US
Mailing Address - Phone:702-560-2192
Mailing Address - Fax:
Practice Address - Street 1:1771 E FLAMINGO RD STE 220A
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-0850
Practice Address - Country:US
Practice Address - Phone:025-602-1927
Practice Address - Fax:866-241-4406
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-18
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-20-41395103K00000X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst