Provider Demographics
NPI:1528891181
Name:SKALA, LAUREN ASHLEY (LMT CLT CEMT TTT)
Entity type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:ASHLEY
Last Name:SKALA
Suffix:
Gender:F
Credentials:LMT CLT CEMT TTT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1341 SULLIVAN LN
Mailing Address - Street 2:
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-8758
Mailing Address - Country:US
Mailing Address - Phone:502-526-7369
Mailing Address - Fax:
Practice Address - Street 1:1729 HIGHWAY 44 E STE A
Practice Address - Street 2:
Practice Address - City:SHEPHERDSVILLE
Practice Address - State:KY
Practice Address - Zip Code:40165-7146
Practice Address - Country:US
Practice Address - Phone:502-526-7369
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY245605225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist