Provider Demographics
NPI:1306348412
Name:CRESPI, LAUREN ASHLEY (MS, CCC-SLP, TSSLD)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:ASHLEY
Last Name:CRESPI
Suffix:
Gender:F
Credentials:MS, CCC-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 CHESS LOOP
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-6183
Mailing Address - Country:US
Mailing Address - Phone:347-675-8803
Mailing Address - Fax:
Practice Address - Street 1:380 GENESEE AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-3202
Practice Address - Country:US
Practice Address - Phone:718-984-3800
Practice Address - Fax:718-227-6358
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY14129249235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist