Provider Demographics
NPI:1437762994
Name:BRANDEEN, LAUREN ALEXANDRA (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ALEXANDRA
Last Name:BRANDEEN
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16802 ISLAND AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-4949
Mailing Address - Country:US
Mailing Address - Phone:612-618-9292
Mailing Address - Fax:
Practice Address - Street 1:815 FOREST AVE
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55057-1643
Practice Address - Country:US
Practice Address - Phone:507-664-8800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN10519235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty