Provider Demographics
NPI:1326716465
Name:WIREBACH, LAUREN N (AUD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:N
Last Name:WIREBACH
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:N
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19110 MONTGOMERY VILLAGE AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-3706
Mailing Address - Country:US
Mailing Address - Phone:301-977-6317
Mailing Address - Fax:301-977-8503
Practice Address - Street 1:1700 KINGFISHER DR STE 27
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4771
Practice Address - Country:US
Practice Address - Phone:301-846-0222
Practice Address - Fax:301-846-7707
Is Sole Proprietor?:No
Enumeration Date:2021-09-02
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01572237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter