Provider Demographics
NPI:1265038004
Name:AYALA, LAUREN EMILY (MS, CF-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:EMILY
Last Name:AYALA
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:MS
Other - First Name:LAUREN
Other - Middle Name:EMILY
Other - Last Name:SHEDD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5576 SIX MILE COMMERCIAL CT APT 111
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33912-4496
Mailing Address - Country:US
Mailing Address - Phone:813-417-9171
Mailing Address - Fax:
Practice Address - Street 1:15071 SHELL POINT BLVD
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-1639
Practice Address - Country:US
Practice Address - Phone:239-415-5432
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ9920235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist