Provider Demographics
NPI:1447075973
Name:MALINOWSKI, LAUREN
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:MALINOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 CENTER RD APT 271
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06612-9992
Mailing Address - Country:US
Mailing Address - Phone:203-653-8299
Mailing Address - Fax:
Practice Address - Street 1:295 CENTER RD APT 271
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:CT
Practice Address - Zip Code:06612-9992
Practice Address - Country:US
Practice Address - Phone:203-653-8299
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTRBT-18-58165106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician