Provider Demographics
NPI:1215549126
Name:STOVER, LAUREN GRACE (MA CF-SLP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:GRACE
Last Name:STOVER
Suffix:
Gender:F
Credentials:MA CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 OLDMAN RD
Mailing Address - Street 2:
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-8540
Mailing Address - Country:US
Mailing Address - Phone:330-988-1111
Mailing Address - Fax:
Practice Address - Street 1:515 OLDMAN RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-8540
Practice Address - Country:US
Practice Address - Phone:330-988-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2020-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOND.20201365-SP235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist