Provider Demographics
NPI:1720539596
Name:GARRIGUS, LAUREN ANNE
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ANNE
Last Name:GARRIGUS
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 1:43279 SCHOENHERR RD
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48313-1957
Mailing Address - Country:US
Mailing Address - Phone:313-278-4601
Mailing Address - Fax:313-347-1652
Practice Address - Street 1:43279 SCHOENHERR RD
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48313-1957
Practice Address - Country:US
Practice Address - Phone:313-278-4601
Practice Address - Fax:313-347-1652
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2022-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
MI7152000301235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other