Provider Demographics
NPI:1326349606
Name:GLUECK, LAUREN (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:GLUECK
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 1:41 HEATH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04963-4901
Mailing Address - Country:US
Mailing Address - Phone:207-465-2435
Mailing Address - Fax:207-465-4983
Practice Address - Street 1:55 PLEASANT ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:ME
Practice Address - Zip Code:04963-5054
Practice Address - Country:US
Practice Address - Phone:207-465-2965
Practice Address - Fax:207-465-4985
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-03
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESP1335235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist