Provider Demographics
NPI:1467630434
Name:HIXON, LAUREN M (MSCCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:M
Last Name:HIXON
Suffix:
Gender:F
Credentials:MSCCCSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 EDMONDSON AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-4714
Mailing Address - Country:US
Mailing Address - Phone:443-809-0803
Mailing Address - Fax:
Practice Address - Street 1:2301 EDMONDSON AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-4714
Practice Address - Country:US
Practice Address - Phone:443-809-0803
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-01
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2589235Z00000X
MD09981235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist