Provider Demographics
NPI:1306410048
Name:ZINNERSHINE, LAUREN STEPHANIE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:STEPHANIE
Last Name:ZINNERSHINE
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520-1514
Mailing Address - Country:US
Mailing Address - Phone:541-482-2341
Mailing Address - Fax:
Practice Address - Street 1:135 MAPLE ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520-1514
Practice Address - Country:US
Practice Address - Phone:541-482-2341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-17
Last Update Date:2023-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC15448235Z00000X
MA78235235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA