Provider Demographics
NPI:1477391308
Name:COLLINS, LAUREN NICOLE (SLP)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:NICOLE
Last Name:COLLINS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 E 96TH ST # 140
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-3731
Mailing Address - Country:US
Mailing Address - Phone:317-525-8386
Mailing Address - Fax:844-556-4672
Practice Address - Street 1:1300 E 96TH ST # 140
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-3731
Practice Address - Country:US
Practice Address - Phone:317-525-8386
Practice Address - Fax:844-556-4672
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22005579A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist