Provider Demographics
NPI:1093199333
Name:HARTSOOK, LAUREN (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:HARTSOOK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:KS
Mailing Address - Zip Code:66938-9511
Mailing Address - Country:US
Mailing Address - Phone:785-614-1912
Mailing Address - Fax:
Practice Address - Street 1:1016 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:CLYDE
Practice Address - State:KS
Practice Address - Zip Code:66938-9511
Practice Address - Country:US
Practice Address - Phone:785-614-1912
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-16
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3648235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist