Provider Demographics
NPI:1740923101
Name:WILLIAMSON, LAUREN GRICE (MSP, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:GRICE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:MSP, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:186 SEVEN FARMS DRIVE
Mailing Address - Street 2:SUITE F #356
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29492
Mailing Address - Country:US
Mailing Address - Phone:803-814-3812
Mailing Address - Fax:
Practice Address - Street 1:186 SEVEN FARMS DRIVE
Practice Address - Street 2:SUITE F #356
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29492
Practice Address - Country:US
Practice Address - Phone:803-814-3812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2022-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6478235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist