Provider Demographics
NPI:1245481134
Name:LOCKWOOD, LAUREN JEAN (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:JEAN
Last Name:LOCKWOOD
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 BROAD ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18337-1355
Mailing Address - Country:US
Mailing Address - Phone:570-296-3992
Mailing Address - Fax:
Practice Address - Street 1:221 BROAD ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:PA
Practice Address - Zip Code:18337-1355
Practice Address - Country:US
Practice Address - Phone:570-296-3992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL004466L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist