Provider Demographics
NPI:1356833917
Name:PITEK, LAUREN MARIE (AUD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:MARIE
Last Name:PITEK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1115 STARWOOD AVE APT 30
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68803-1449
Mailing Address - Country:US
Mailing Address - Phone:434-872-3184
Mailing Address - Fax:
Practice Address - Street 1:1115 STARWOOD AVE APT 30
Practice Address - Street 2:
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68803-1449
Practice Address - Country:US
Practice Address - Phone:434-872-3184
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist