Provider Demographics
NPI:1093167900
Name:SMITH, LAUREN NICOLE (MS, CF-SLP)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:NICOLE
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 N VALENCIA PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-5061
Mailing Address - Country:US
Mailing Address - Phone:480-628-4319
Mailing Address - Fax:
Practice Address - Street 1:3160 N ARIZONA AVE
Practice Address - Street 2:SUITE 109
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-7122
Practice Address - Country:US
Practice Address - Phone:480-365-9981
Practice Address - Fax:480-963-9126
Is Sole Proprietor?:No
Enumeration Date:2016-07-05
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZTSLP15643235Z00000X
2355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant