Provider Demographics
NPI:1124600820
Name:CROCKETT, LAUREN JULIANA (MS, CF-SLP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:JULIANA
Last Name:CROCKETT
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:JULIANA
Other - Last Name:MENELLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CF-SLP
Mailing Address - Street 1:5533 MAHONING AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2366
Mailing Address - Country:US
Mailing Address - Phone:330-729-1470
Mailing Address - Fax:330-729-1530
Practice Address - Street 1:5533 MAHONING AVE FL 2
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2366
Practice Address - Country:US
Practice Address - Phone:330-729-1470
Practice Address - Fax:330-729-1530
Is Sole Proprietor?:No
Enumeration Date:2021-04-22
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist