Provider Demographics
NPI:1790538148
Name:LAWRENCE, SYDNE KAY (SLPA)
Entity Type:Individual
Prefix:MRS
First Name:SYDNE
Middle Name:KAY
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 MARIGOLD ST NE
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-1933
Mailing Address - Country:US
Mailing Address - Phone:503-269-7109
Mailing Address - Fax:
Practice Address - Street 1:1700 MARIGOLD ST NE
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-1933
Practice Address - Country:US
Practice Address - Phone:503-269-7109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA79062355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant