Provider Demographics
NPI:1548092158
Name:ERDMAN, LAUREN MARIE
Entity type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:MARIE
Last Name:ERDMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 S DARROWBY DR
Mailing Address - Street 2:
Mailing Address - City:RAYMORE
Mailing Address - State:MO
Mailing Address - Zip Code:64083-8133
Mailing Address - Country:US
Mailing Address - Phone:816-721-3707
Mailing Address - Fax:
Practice Address - Street 1:2500 HIGH GROVE RD
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:MO
Practice Address - Zip Code:64030-5400
Practice Address - Country:US
Practice Address - Phone:816-316-5500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024029604235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist