Provider Demographics
NPI:1356868152
Name:LAWREY, DEVON (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DEVON
Middle Name:
Last Name:LAWREY
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 1:101 WASHINGTON AVE STE B
Mailing Address - Street 2:PMB# 177
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417-1331
Mailing Address - Country:US
Mailing Address - Phone:248-622-9198
Mailing Address - Fax:616-369-1066
Practice Address - Street 1:18019 MOHAWK DR
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:MI
Practice Address - Zip Code:49456-9122
Practice Address - Country:US
Practice Address - Phone:248-622-9198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-23
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017029526235Z00000X
MI7101005461235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist