Provider Demographics
NPI:1124220611
Name:ROGERS, LAUREN GLASGOW (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:GLASGOW
Last Name:ROGERS
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 JACKLYN CT
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-7554
Mailing Address - Country:US
Mailing Address - Phone:270-634-0077
Mailing Address - Fax:
Practice Address - Street 1:161 JACKLYN CT
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-7554
Practice Address - Country:US
Practice Address - Phone:502-451-2142
Practice Address - Fax:502-451-2740
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-3247235Z00000X
KY142441235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1463OtherCBIS PROVIDER NUMBER