Provider Demographics
NPI:1376071738
Name:FEDT, LAUREN ALEXANDRA (AUD)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ALEXANDRA
Last Name:FEDT
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 1:9017 W BIRCHOVER DR
Mailing Address - Street 2:
Mailing Address - City:MARANA
Mailing Address - State:AZ
Mailing Address - Zip Code:85653-8928
Mailing Address - Country:US
Mailing Address - Phone:214-551-9892
Mailing Address - Fax:
Practice Address - Street 1:2542 E VISTOSO COMMERCE LOOP
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-9123
Practice Address - Country:US
Practice Address - Phone:520-825-4770
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist