Individual
LAUREN BUCKHAULT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MED., BCBA
Contact information
Practice address
585 MOLLY LN, WOODSTOCK, GA 30189-3721
(877) 288-4760
Mailing address
15 CROSSFIRE DR, COVINGTON, GA 30014-8941
(678) 629-0064
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-19-35405
GA
Other
Enumeration date
04/10/2019
Last updated
10/03/2023
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