Provider Demographics
NPI:1609631340
Name:HAMNER, LAUREN FREY (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:FREY
Last Name:HAMNER
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 1:405 BALMORAL RD
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-5201
Mailing Address - Country:US
Mailing Address - Phone:407-761-7710
Mailing Address - Fax:
Practice Address - Street 1:400 S ORLANDO AVE STE 204
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5644
Practice Address - Country:US
Practice Address - Phone:407-900-3026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA4524235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist