Provider Demographics
NPI:1922486950
Name:ANDERSON, LAUREN (MA, CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3675 SE 38TH TERRACE
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34480
Mailing Address - Country:US
Mailing Address - Phone:352-342-2205
Mailing Address - Fax:
Practice Address - Street 1:3675 SE 38TH TER
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34480-6345
Practice Address - Country:US
Practice Address - Phone:352-342-2205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2015-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7483235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist