Healthcare Provider Details

I. General information

NPI: 1205542453
Provider Name (Legal Business Name): LAUREN MAE HEROLD MA, CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2023
Last Update Date: 01/30/2023
Certification Date: 01/30/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 PILLSBURY ST STE 404
CONCORD NH
03301-3549
US

IV. Provider business mailing address

2 PILLSBURY ST STE 404
CONCORD NH
03301-3549
US

V. Phone/Fax

Practice location:
  • Phone: 603-228-7827
  • Fax: 603-228-7828
Mailing address:
  • Phone: 603-228-7827
  • Fax: 603-228-7828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberP-0943
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: