MEDICARE: MS. LAUREN ANN LAY MA, TLLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator
2	103T00000X	Psychologist	6301018006	MI

General Provider Information

NPI Number	:	1003157520
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. LAUREN ANN LAY MA, TLLP

Provider Business Mailing Address
First Line	:	2811 E COURT ST
Second Line	:	SUITE F
City	:	FLINT
State	:	MI
Zip	:	48506-4054
Country	:	US
Telephone Number	:	810-232-6081
Fax Number	:	810-232-6510

Provider Business Practice Location Address
First Line	:	202 W SHIAWASSEE AVE STE 213
Second Line	:
City	:	FENTON
State	:	MI
Zip	:	48430-2093
Country	:	US
Telephone Number	:	248-245-2520
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2013
Last Update Date	:	08/29/2019

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