Provider Demographics
NPI:1528399722
Name:GEBAUER, LAUREN ELISE (MT-BC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELISE
Last Name:GEBAUER
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 N ALMA SCHOOL RD
Mailing Address - Street 2:SUITE 366
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-2815
Mailing Address - Country:US
Mailing Address - Phone:602-403-8800
Mailing Address - Fax:480-917-3424
Practice Address - Street 1:1990 N ALMA SCHOOL RD
Practice Address - Street 2:SUITE 366
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2815
Practice Address - Country:US
Practice Address - Phone:602-403-8800
Practice Address - Fax:480-917-3424
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist