Provider Demographics
NPI:1265091839
Name:MALO, LAUREN (MS)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:MALO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4817 N 133RD PLZ APT 1031
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68164-1068
Mailing Address - Country:US
Mailing Address - Phone:507-475-2143
Mailing Address - Fax:
Practice Address - Street 1:8424 W CENTER RD STE 214
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-3138
Practice Address - Country:US
Practice Address - Phone:507-475-2143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-07
Last Update Date:2019-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health