Provider Demographics
NPI:1053507343
Name:MCINTOSH, LAUREN CHRISTINE (MS CCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:CHRISTINE
Last Name:MCINTOSH
Suffix:
Gender:F
Credentials:MS CCCSLP
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:CHRISTINE
Other - Last Name:MOUNTJOY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10965 WINDS CROSSING DR
Mailing Address - Street 2:SUITE #100
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:21273-2400
Mailing Address - Country:US
Mailing Address - Phone:704-504-2194
Mailing Address - Fax:704-504-2197
Practice Address - Street 1:10965 WINDS CROSSING DR
Practice Address - Street 2:SUITE #100
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:21273-2400
Practice Address - Country:US
Practice Address - Phone:704-504-2194
Practice Address - Fax:704-504-2197
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7562235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist