Provider Demographics
NPI:1750604500
Name:LAUR, LAUREN E (SLP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:LAUR
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 1:4417 W NORTH PINEBROOK LN
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-0589
Mailing Address - Country:US
Mailing Address - Phone:816-914-9960
Mailing Address - Fax:
Practice Address - Street 1:2001 CORONA RD
Practice Address - Street 2:SUITE 205
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203
Practice Address - Country:US
Practice Address - Phone:816-914-9960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010002035235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist