Provider Demographics
NPI:1982056826
Name:LAZARUS, LACHELLE MAUREEN (AUD)
Entity Type:Individual
Prefix:
First Name:LACHELLE
Middle Name:MAUREEN
Last Name:LAZARUS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 AUTUMN BRANCH LN APT J
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21043-3552
Mailing Address - Country:US
Mailing Address - Phone:954-682-6081
Mailing Address - Fax:
Practice Address - Street 1:16 S EUTAW ST STE 400
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-1699
Practice Address - Country:US
Practice Address - Phone:410-328-5948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-04
Last Update Date:2020-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01487231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist