Provider Demographics
NPI:1144803610
Name:ROEDER, LAUREN VICTORIA (AUD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:VICTORIA
Last Name:ROEDER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16106 E EASTER CIR UNIT 303
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80016-5077
Mailing Address - Country:US
Mailing Address - Phone:916-202-2996
Mailing Address - Fax:
Practice Address - Street 1:201 9TH ST
Practice Address - Street 2:
Practice Address - City:MARINA
Practice Address - State:CA
Practice Address - Zip Code:93933-6039
Practice Address - Country:US
Practice Address - Phone:831-884-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-03
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist