Provider Demographics
NPI:1972890473
Name:MCCOOLE, LAUREN (AUD)
Entity type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:MCCOOLE
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:
Other - Last Name:LAWLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:15825 MANCHESTER RD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:ELLISVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63011-2263
Mailing Address - Country:US
Mailing Address - Phone:314-989-8877
Mailing Address - Fax:
Practice Address - Street 1:10094 LITZSINGER RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-1132
Practice Address - Country:US
Practice Address - Phone:314-989-8877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-05
Last Update Date:2012-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011015904231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist