Provider Demographics
NPI:1013343656
Name:DEAN, LAUREN MICHELLE (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:MICHELLE
Last Name:DEAN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7288 MILL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:HAHIRA
Mailing Address - State:GA
Mailing Address - Zip Code:31632-2255
Mailing Address - Country:US
Mailing Address - Phone:678-850-8976
Mailing Address - Fax:229-375-0536
Practice Address - Street 1:7288 MILL RIDGE DR
Practice Address - Street 2:
Practice Address - City:HAHIRA
Practice Address - State:GA
Practice Address - Zip Code:31632-2255
Practice Address - Country:US
Practice Address - Phone:678-850-8976
Practice Address - Fax:229-375-0536
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-14
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6984235Z00000X
GASLP008180235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist