MEDICARE: LAUREN ELIZABETH HOLDEN

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	235Z00000X	Speech-Language Pathologist	22006449A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023215076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN ELIZABETH HOLDEN

Provider Business Mailing Address
First Line	:	PO BOX 778912
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-8912
Country	:	US
Telephone Number	:	317-777-6435
Fax Number	:	317-777-6644

Provider Business Practice Location Address
First Line	:	7478 SHADELAND STATION WAY
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46256-3925
Country	:	US
Telephone Number	:	317-288-7606
Fax Number	:

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

Provider Enumeration Date	:	07/02/2007
Last Update Date	:	09/20/2023

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Directions to “ LAUREN ELIZABETH HOLDEN ” Practice Location

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