Provider Demographics
NPI:1790013639
Name:STOWE, LAUREN M (PHD, CCC-SLP)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:M
Last Name:STOWE
Suffix:
Gender:F
Credentials:PHD, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 JOYCE CT
Mailing Address - Street 2:
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93401-5324
Mailing Address - Country:US
Mailing Address - Phone:805-458-2232
Mailing Address - Fax:805-416-2422
Practice Address - Street 1:1304 ELLA ST
Practice Address - Street 2:STE B2
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401-4162
Practice Address - Country:US
Practice Address - Phone:805-458-2232
Practice Address - Fax:805-458-2232
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-04
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13748235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist