Provider Demographics
NPI:1679702526
Name:HARRELL, LAUREN M LANDGRAF (MS-CCC, SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:M LANDGRAF
Last Name:HARRELL
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 1:1807A E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-3841
Mailing Address - Country:US
Mailing Address - Phone:864-442-7482
Mailing Address - Fax:864-306-7977
Practice Address - Street 1:1807A E MAIN ST
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3841
Practice Address - Country:US
Practice Address - Phone:864-442-7482
Practice Address - Fax:864-306-7977
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-13
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC283XC2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes283XC2000XHospitalsRehabilitation HospitalChildren