Provider Demographics
NPI:1154734002
Name:HOOPER, LAUREN (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:HOOPER
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5302 NORRISVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:MD
Mailing Address - Zip Code:21161-8995
Mailing Address - Country:US
Mailing Address - Phone:410-692-7810
Mailing Address - Fax:
Practice Address - Street 1:5302 NORRISVILLE RD
Practice Address - Street 2:
Practice Address - City:WHITE HALL
Practice Address - State:MD
Practice Address - Zip Code:21161-8924
Practice Address - Country:US
Practice Address - Phone:410-692-7810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD06603235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1154734002Medicaid