Provider Demographics
NPI:1538461298
Name:MORAVEC, LAUREN CHRISTINE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:CHRISTINE
Last Name:MORAVEC
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 HAYDEN ST
Mailing Address - Street 2:
Mailing Address - City:HENRIETTA
Mailing Address - State:NY
Mailing Address - Zip Code:14467-9321
Mailing Address - Country:US
Mailing Address - Phone:585-451-2083
Mailing Address - Fax:
Practice Address - Street 1:22 HAYDEN ST
Practice Address - Street 2:
Practice Address - City:HENRIETTA
Practice Address - State:NY
Practice Address - Zip Code:14467-9321
Practice Address - Country:US
Practice Address - Phone:585-451-2083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-30
Last Update Date:2010-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015710-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist