Individual
LAUREN M IMMENSCHUH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA, BCBA
Contact information
Practice address
1850 LOCKHILL SELMA RD STE 106, SAN ANTONIO, TX 78213-1552
(210) 643-1119
Mailing address
7207 DUBIES DR, SAN ANTONIO, TX 78216-7114
(210) 979-1513
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
4315
TX
106S00000X
Behavior Technician
RBT-20-113497
TX
Other
Enumeration date
05/26/2020
Last updated
08/10/2021
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