Healthcare Provider Details

I. General information

NPI: 1316851926
Provider Name (Legal Business Name): LAUREN M PRESTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2026
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 RUTLEDGE AVE
CHARLESTON SC
29425-8903
US

IV. Provider business mailing address

1000 BOOPA LN
MOUNT PLEASANT SC
29464-5548
US

V. Phone/Fax

Practice location:
  • Phone: 843-876-1308
  • Fax:
Mailing address:
  • Phone: 215-870-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberAUD.8067
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: