Provider Demographics
NPI:1619374121
Name:KLEIN, LAUREN RAY (MS, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:RAY
Last Name:KLEIN
Suffix:
Gender:F
Credentials:MS, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1170 PENINSULA BLVD
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1247
Mailing Address - Country:US
Mailing Address - Phone:516-792-4300
Mailing Address - Fax:
Practice Address - Street 1:1170 PENINSULA BLVD
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1247
Practice Address - Country:US
Practice Address - Phone:516-792-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-26
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009479235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist