Basic Information
| Provider Information | |||||||||
| NPI: | 1932681749 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BARNETT | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | |||||||||
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| OtherLastName: | DANIELS | ||||||||
| OtherFirstName: | LAUREN | ||||||||
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| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 711 AVIGNON DR | ||||||||
| Address2: | |||||||||
| City: | RIDGELAND | ||||||||
| State: | MS | ||||||||
| PostalCode: | 391575120 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6016056777 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 135 RESIDENTIAL CENTER RD | ||||||||
| Address2: | |||||||||
| City: | CHOCTAW | ||||||||
| State: | MS | ||||||||
| PostalCode: | 393506780 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6013892812 | ||||||||
| FaxNumber: | 6016071417 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2018 | ||||||||
| LastUpdateDate: | 08/29/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | S4474 | MS | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.