Provider Demographics
NPI:1760798623
Name:MULVAUGH, LAUREN BARBARA
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:BARBARA
Last Name:MULVAUGH
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 1:701 CAMINO DEL RIO STE 221
Mailing Address - Street 2:
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5466
Mailing Address - Country:US
Mailing Address - Phone:970-946-2133
Mailing Address - Fax:
Practice Address - Street 1:701 CAMINO DEL RIO STE 221
Practice Address - Street 2:
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5466
Practice Address - Country:US
Practice Address - Phone:970-946-2133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-28
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP6949235Z00000X
CO17083951235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist