Provider Demographics
NPI:1134749823
Name:MATHER, LAUREN ELISABETH (MED)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELISABETH
Last Name:MATHER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 TALS ROCK WAY STE 3
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-1919
Mailing Address - Country:US
Mailing Address - Phone:425-999-0381
Mailing Address - Fax:
Practice Address - Street 1:210 TALS ROCK WAY STE 3
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-1919
Practice Address - Country:US
Practice Address - Phone:425-999-0381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-22
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician