Provider Demographics
NPI:1518448356
Name:SCOTT HEDAYAT, LAUREN
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:SCOTT HEDAYAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:105 N MAIN
Mailing Address - Street 2:
Mailing Address - City:SAVOY
Mailing Address - State:TX
Mailing Address - Zip Code:75479-2133
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:105 N MAIN
Practice Address - Street 2:
Practice Address - City:SAVOY
Practice Address - State:TX
Practice Address - Zip Code:75479-2133
Practice Address - Country:US
Practice Address - Phone:903-965-0200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113417235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist