Provider Demographics
NPI:1407943384
Name:COLLINS, LAUREN M (SPEECH PATHOLOGIST)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:M
Last Name:COLLINS
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGIST
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Mailing Address - Street 1:8833 OSPREY LN
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-4719
Mailing Address - Country:US
Mailing Address - Phone:904-733-1278
Mailing Address - Fax:904-280-7680
Practice Address - Street 1:228 PONTE VEDRA PARK DR
Practice Address - Street 2:SUITE 800
Practice Address - City:PONTE VEDRA
Practice Address - State:FL
Practice Address - Zip Code:32082-6613
Practice Address - Country:US
Practice Address - Phone:904-280-0081
Practice Address - Fax:904-280-7680
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLSA6864235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist