Provider Demographics
NPI:1356861058
Name:BECKWITH, LAUREN (MS ED)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:BECKWITH
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3341 ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:BLASDELL
Mailing Address - State:NY
Mailing Address - Zip Code:14219-2233
Mailing Address - Country:US
Mailing Address - Phone:617-239-7005
Mailing Address - Fax:
Practice Address - Street 1:1025 RIDGE RD
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14218-1755
Practice Address - Country:US
Practice Address - Phone:716-825-8644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-23
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028396235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist