Provider Demographics
NPI:1063764769
Name:BIDDISON, LAUREN ASHLEY (MA, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ASHLEY
Last Name:BIDDISON
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Gender:F
Credentials:MA, CCC-SLP
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Mailing Address - Street 1:2330 IMMOKALEE RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1414
Mailing Address - Country:US
Mailing Address - Phone:239-596-0831
Mailing Address - Fax:239-596-2155
Practice Address - Street 1:2330 IMMOKALEE RD
Practice Address - Street 2:SUITE 2
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34110-1414
Practice Address - Country:US
Practice Address - Phone:239-596-0831
Practice Address - Fax:239-596-2155
Is Sole Proprietor?:No
Enumeration Date:2012-10-05
Last Update Date:2012-10-05
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Provider Licenses
StateLicense IDTaxonomies
FLSA9619235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist