Provider Demographics
NPI:1376281790
Name:LAUREN BAIR M.A. CCC-SLP, LLC
Entity Type:Organization
Organization Name:LAUREN BAIR M.A. CCC-SLP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:BAIR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-704-2637
Mailing Address - Street 1:187 GODFREYS GATE
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-6453
Mailing Address - Country:US
Mailing Address - Phone:215-704-2637
Mailing Address - Fax:
Practice Address - Street 1:1845 W MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-1054
Practice Address - Country:US
Practice Address - Phone:908-509-7340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-25
Last Update Date:2022-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center