Provider Demographics
NPI:1346687381
Name:SLOAN, LAUREN M (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:SLOAN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 PHEASANT DR
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-4913
Mailing Address - Country:US
Mailing Address - Phone:917-710-5522
Mailing Address - Fax:
Practice Address - Street 1:8527 247TH ST
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-2141
Practice Address - Country:US
Practice Address - Phone:917-710-5522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022744-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist