Provider Demographics
NPI:1912207291
Name:GAEDKE, LAUREN MICHELLE
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:MICHELLE
Last Name:GAEDKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 N CENTRAL AVE
Mailing Address - Street 2:#502
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1316
Mailing Address - Country:US
Mailing Address - Phone:602-820-4226
Mailing Address - Fax:
Practice Address - Street 1:7120 E SAHUARO DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-6181
Practice Address - Country:US
Practice Address - Phone:602-820-4226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-02
Last Update Date:2010-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant