Provider Demographics
NPI:1689561474
Name:BENNETT, LAURYN MADISYN
Entity type:Individual
Prefix:
First Name:LAURYN
Middle Name:MADISYN
Last Name:BENNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3913 HIGHWAY 14
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560-9435
Mailing Address - Country:US
Mailing Address - Phone:337-201-5905
Mailing Address - Fax:
Practice Address - Street 1:3913 HIGHWAY 14
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-9435
Practice Address - Country:US
Practice Address - Phone:337-201-5905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9893235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist