Provider Demographics
NPI:1871830315
Name:BURKE, LAUREN (MSP)
Entity Type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:BURKE
Suffix:
Gender:F
Credentials:MSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 BENTLEY DR
Mailing Address - Street 2:APT 321
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29210-7980
Mailing Address - Country:US
Mailing Address - Phone:803-568-1200
Mailing Address - Fax:
Practice Address - Street 1:3900 BENTLEY DR
Practice Address - Street 2:APT 324
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29210-7980
Practice Address - Country:US
Practice Address - Phone:803-568-1200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist