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NPI Code Detail

MEDICARE: LAUREN ABERNETHY M.A., CCC-SLP

MEDICARE: LAUREN ABERNETHY M.A., CCC-SLP
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
1235Z00000XSpeech-Language PathologistSA13240FL

Other Identifiers

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

General Provider Information

NPI Number : 1710414776
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN ABERNETHY M.A., CCC-SLP
Provider Business Mailing Address
First Line : 2721 OAK ALLEY DR
Second Line :
City : FORT PIERCE
State : FL
Zip : 34981-5083
Country : US
Telephone Number : 321-368-1032
Fax Number : 772-461-9954
Provider Business Practice Location Address
First Line : 4715 KIRBY LOOP RD
Second Line :
City : FORT PIERCE
State : FL
Zip : 34981-5345
Country : US
Telephone Number : 772-577-6964
Fax Number : 772-577-6964
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2017
Last Update Date : 05/21/2017

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