Provider Demographics
NPI:1174814586
Name:YANIKE, LAUREN RACHEL (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:RACHEL
Last Name:YANIKE
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 1:226 CREEK WALK DR
Mailing Address - Street 2:
Mailing Address - City:WALKERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21793-6003
Mailing Address - Country:US
Mailing Address - Phone:443-536-6800
Mailing Address - Fax:
Practice Address - Street 1:56 W FREDERICK ST
Practice Address - Street 2:
Practice Address - City:WALKERSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21793-8254
Practice Address - Country:US
Practice Address - Phone:301-898-4321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-20
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06142235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist