Provider Demographics
NPI:1528835188
Name:BOLLEN, LAUREN FOSTER (MED CCC-SLP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:FOSTER
Last Name:BOLLEN
Suffix:
Gender:F
Credentials:MED CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 WASH CREEK DR UNIT G
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28739-4638
Mailing Address - Country:US
Mailing Address - Phone:706-699-4808
Mailing Address - Fax:
Practice Address - Street 1:252 WASH CREEK DR UNIT G
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28739-4638
Practice Address - Country:US
Practice Address - Phone:706-699-4808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC11702235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist