Provider Demographics
NPI:1881961274
Name:PARTIN, LAUREN ASHLEY
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:ASHLEY
Last Name:PARTIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10102 S OCEAN DR
Mailing Address - Street 2:APT 704
Mailing Address - City:JENSEN BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:34957-2562
Mailing Address - Country:US
Mailing Address - Phone:718-909-7151
Mailing Address - Fax:
Practice Address - Street 1:10102 S OCEAN DR
Practice Address - Street 2:APT 704
Practice Address - City:JENSEN BEACH
Practice Address - State:FL
Practice Address - Zip Code:34957-2562
Practice Address - Country:US
Practice Address - Phone:718-909-7151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-29
Last Update Date:2011-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSAM 11195235Z00000X
TX105547235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist