Provider Demographics
NPI:1720742000
Name:GHENT, LAUREN WEIL
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:WEIL
Last Name:GHENT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1180 VIEWMONT DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-5792
Mailing Address - Country:US
Mailing Address - Phone:847-404-6562
Mailing Address - Fax:
Practice Address - Street 1:3031 WESTERLY DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-8594
Practice Address - Country:US
Practice Address - Phone:615-663-8872
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-24
Last Update Date:2021-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician