Provider Demographics
NPI:1447792403
Name:WALSH, LAUREN KRASNER (MS, AT, ATC, CSCS)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:KRASNER
Last Name:WALSH
Suffix:
Gender:F
Credentials:MS, AT, ATC, CSCS
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:KRASNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:920 E GLENMERE DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-6429
Mailing Address - Country:US
Mailing Address - Phone:520-488-8592
Mailing Address - Fax:
Practice Address - Street 1:240 W THOMAS RD STE 302
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4407
Practice Address - Country:US
Practice Address - Phone:602-406-4762
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-08
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13322255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer