Provider Demographics
NPI:1588849012
Name:WARREN, LAUREN G (MCD CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:G
Last Name:WARREN
Suffix:
Gender:F
Credentials:MCD CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 ROTHERHAM CT
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-3170
Mailing Address - Country:US
Mailing Address - Phone:727-785-0998
Mailing Address - Fax:727-785-0998
Practice Address - Street 1:4215 ROTHERHAM CT
Practice Address - Street 2:
Practice Address - City:PALM HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34685-3170
Practice Address - Country:US
Practice Address - Phone:727-785-0998
Practice Address - Fax:727-785-0998
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-03
Last Update Date:2008-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 3605235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist