Provider Demographics
NPI:1013414499
Name:PURCELL, LAUREN ALEXANDRIA
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:ALEXANDRIA
Last Name:PURCELL
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 1:1858 N HARVEST PKWY
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-5246
Mailing Address - Country:US
Mailing Address - Phone:408-772-5661
Mailing Address - Fax:
Practice Address - Street 1:398 S CORBIN RD
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-8139
Practice Address - Country:US
Practice Address - Phone:208-981-1111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-11
Last Update Date:2021-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist