Individual
LAUREN ELISA FAUST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5415C BACKLICK RD, SPRINGFIELD, VA 22151-3915
(703) 941-1910
Mailing address
12424 LISBOROUGH RD, BOWIE, MD 20720-3412
(240) 535-9747
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
JHZ905110567
CAREFIRST BLUECHOICE, INC
—
Enumeration date
09/25/2018
Last updated
09/25/2018
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