Provider Demographics
NPI:1811545452
Name:KAUR, SIMRAN (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:SIMRAN
Middle Name:
Last Name:KAUR
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-1846
Mailing Address - Country:US
Mailing Address - Phone:203-400-7011
Mailing Address - Fax:
Practice Address - Street 1:21820 BURBANK BLVD # 310B
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6476
Practice Address - Country:US
Practice Address - Phone:203-400-7011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD09530235Z00000X
CT18.006391235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist