Provider Demographics
NPI:1588314942
Name:CUNNINGHAM, LAUREN M (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:M
Last Name:CUNNINGHAM
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 1:4848 LEMMON AVE STE 100-144
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-1400
Mailing Address - Country:US
Mailing Address - Phone:210-380-5326
Mailing Address - Fax:
Practice Address - Street 1:4848 LEMMON AVE STE 100-144
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-1400
Practice Address - Country:US
Practice Address - Phone:210-380-5326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2023-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX111359235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty