Provider Demographics
NPI:1710330626
Name:THOMPSON, LAUREN CHRISTINE
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:CHRISTINE
Last Name:THOMPSON
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 1:184 BRAGG HILL RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-6714
Mailing Address - Country:US
Mailing Address - Phone:570-430-3313
Mailing Address - Fax:
Practice Address - Street 1:184 BRAGG HILL RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-6714
Practice Address - Country:US
Practice Address - Phone:570-430-3313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL013193235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist