Healthcare Provider Details

I. General information

NPI: 1932069143
Provider Name (Legal Business Name): LAUREN NICOLE VAID
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2025
Last Update Date: 11/19/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 FALCON HILL TRL
O FALLON MO
63368-8193
US

IV. Provider business mailing address

701 FALCON HILL TRL
O FALLON MO
63368-8193
US

V. Phone/Fax

Practice location:
  • Phone: 417-844-6414
  • Fax:
Mailing address:
  • Phone: 417-844-6414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14227261
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number357288
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: