Individual
MRS. LAUREN MICHELLE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
601 5TH ST S, SAINT PETERSBURG, FL 33701-4804
(727) 767-8105
Mailing address
601 5TH ST S, SAINT PETERSBURG, FL 33701-4804
(727) 767-8105
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
P3070
TN
103TC0700X
Clinical Psychologist
P3070
TN
103TC0700X
Clinical Psychologist
Primary
PY9501
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P3070
STATE LICENSE
TN
01
—
PY9501
FLORIDA PSYCHOLOGY BOARD
FL
Enumeration date
01/25/2013
Last updated
11/17/2016
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