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LAUREN HUMPHRIES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
BCBA

Contact information

Practice address
928 DOVER ST, PINGREE GROVE, IL 60140-9180
(630) 347-2654
Mailing address
882 CLOVER LN, PINGREE GROVE, IL 60140-9116
(630) 347-2654

Taxonomy

Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-23-66329
IL
106S00000X
Behavior Technician
18-49444
IL

Other

Enumeration date
05/15/2018
Last updated
12/12/2023
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