Provider Demographics
NPI:1952605404
Name:SWEETSER, LAUREN N (SLA)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:N
Last Name:SWEETSER
Suffix:
Gender:F
Credentials:SLA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 S M ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-0521
Mailing Address - Country:US
Mailing Address - Phone:318-578-9744
Mailing Address - Fax:
Practice Address - Street 1:1733 S M ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-0521
Practice Address - Country:US
Practice Address - Phone:318-578-9744
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-26
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARDDS 5012355S0801X
AR2029212355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARDDS-501OtherSTATE DDS LICENSURE
AR184567721Medicaid