Provider Demographics
NPI:1598857690
Name:FOUCAULT LAWLER, SOPHIE MICHELE (MS CCC SLP L)
Entity Type:Individual
Prefix:MS
First Name:SOPHIE
Middle Name:MICHELE
Last Name:FOUCAULT LAWLER
Suffix:
Gender:F
Credentials:MS CCC SLP L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 INTERLAKEN DR
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-1338
Mailing Address - Country:US
Mailing Address - Phone:847-540-8348
Mailing Address - Fax:847-540-8348
Practice Address - Street 1:832 INTERLAKEN DR
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-1338
Practice Address - Country:US
Practice Address - Phone:847-540-8348
Practice Address - Fax:847-540-8348
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist