Healthcare Provider Details

I. General information

NPI: 1952605404
Provider Name (Legal Business Name): LAUREN N SWEETSER SLA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/26/2010
Last Update Date: 05/23/2025
Certification Date: 05/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1733 S M ST
ROGERS AR
72756-0521
US

IV. Provider business mailing address

1733 S M ST
ROGERS AR
72756-0521
US

V. Phone/Fax

Practice location:
  • Phone: 318-578-9744
  • Fax:
Mailing address:
  • Phone: 318-578-9744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberDDS 501
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number202921
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: