Provider Demographics
NPI:1942947205
Name:LUCAS, LAUREN E (AUD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:LUCAS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:925 CHESTNUT ST FL 6
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-4204
Mailing Address - Country:US
Mailing Address - Phone:215-955-6760
Mailing Address - Fax:
Practice Address - Street 1:925 CHESTNUT ST FL 6
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-4204
Practice Address - Country:US
Practice Address - Phone:215-955-6760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-18
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
PAAT006831231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist