Provider Demographics
NPI:1770903338
Name:CRISMAN, LAUREN BERNARDO (MS)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:BERNARDO
Last Name:CRISMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:LAUREN
Other - Middle Name:ALEXANDRA
Other - Last Name:BERNARDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:101 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-3109
Mailing Address - Country:US
Mailing Address - Phone:866-745-2273
Mailing Address - Fax:
Practice Address - Street 1:600 N MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:VA
Practice Address - Zip Code:22664
Practice Address - Country:US
Practice Address - Phone:540-459-6222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-22
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist