Individual
LAUREN WILLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4352 PICKWICK CIR APT 207, HUNTINGTON BEACH, CA 92649-3125
(510) 604-7554
Mailing address
4352 PICKWICK CIR APT 207, HUNTINGTON BEACH, CA 92649-3125
Taxonomy
Speciality
Code
Description
License number
State
106E00000X
Assistant Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106E00000X
TAXONOMY
—
Enumeration date
12/28/2017
Last updated
12/28/2017
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