Provider Demographics
NPI:1114220555
Name:WESTMORELAND, LAUREN BROUSSARD (MA, L-SLP, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:BROUSSARD
Last Name:WESTMORELAND
Suffix:
Gender:F
Credentials:MA, L-SLP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4009 BARBE WOOD DR
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70605-2352
Mailing Address - Country:US
Mailing Address - Phone:337-274-7066
Mailing Address - Fax:
Practice Address - Street 1:1103 W MCNEESE ST
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5431
Practice Address - Country:US
Practice Address - Phone:337-274-7066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-07
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6049235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist