Healthcare Provider Details

I. General information

NPI: 1780591396
Provider Name (Legal Business Name): LAUREN BUSH M.S. CF-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2308 WADE AVE
ASHTABULA OH
44004-9435
US

IV. Provider business mailing address

118 BELLMORE ST
PAINESVILLE OH
44077-8603
US

V. Phone/Fax

Practice location:
  • Phone: 440-992-1270
  • Fax:
Mailing address:
  • Phone: 440-749-3896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberCOND.20263627-SP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: