Provider Demographics
NPI:1144746942
Name:BERRY, LAUREN LEA (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:LEA
Last Name:BERRY
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:LEA
Other - Last Name:KATER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4157 MALONE AVE
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-3064
Mailing Address - Country:US
Mailing Address - Phone:316-613-1929
Mailing Address - Fax:
Practice Address - Street 1:4645 AVON LN STE 120A
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-1612
Practice Address - Country:US
Practice Address - Phone:469-850-3122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist