Provider Demographics
NPI:1790004851
Name:BARNETT, LAUREN ANNE (MA,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:ANNE
Last Name:BARNETT
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:905 S LAKE JESSUP AVE
Mailing Address - Street 2:
Mailing Address - City:OVIEDO
Mailing Address - State:FL
Mailing Address - Zip Code:32765-8726
Mailing Address - Country:US
Mailing Address - Phone:407-325-0427
Mailing Address - Fax:
Practice Address - Street 1:905 S LAKE JESSUP AVE
Practice Address - Street 2:
Practice Address - City:OVIEDO
Practice Address - State:FL
Practice Address - Zip Code:32765-8726
Practice Address - Country:US
Practice Address - Phone:407-325-0427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-27
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA9935235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist