Provider Demographics
NPI:1295378636
Name:WIER, LAUREN ELIZABETH ROSS (CCC-SLP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ELIZABETH ROSS
Last Name:WIER
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 1:13510 WATERFALL WAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5831
Mailing Address - Country:US
Mailing Address - Phone:409-719-2751
Mailing Address - Fax:
Practice Address - Street 1:3272 N GARLAND AVE
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-3207
Practice Address - Country:US
Practice Address - Phone:409-719-2751
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-17
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122167235Z00000X
IA101550235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist