Provider Demographics
NPI:1023483682
Name:RICHARDSON, LAUREN (BCBA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:RICHARDSON
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 1:8 GUNHURST GARTH
Mailing Address - Street 2:
Mailing Address - City:NOTTINGHAM
Mailing Address - State:MD
Mailing Address - Zip Code:21236-4720
Mailing Address - Country:US
Mailing Address - Phone:410-302-2626
Mailing Address - Fax:
Practice Address - Street 1:500 REDLAND CT
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3264
Practice Address - Country:US
Practice Address - Phone:443-884-5643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-08
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
0-14-5799103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst