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General NPI Number Information
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NPI Number | 1144746942
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Entity Type | Individual
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Provider Name | LAUREN LEA BERRY MA, CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 08/14/2017
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Last Update Date | 01/02/2020
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Provider Practice Location Address
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Address Line | 4645 AVON LN STE 120A
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City | FRISCO
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State | TX
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Zip | 75033-1612
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Country | US
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Telephone | 469-850-3122
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Fax |
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Provider Business Mailing Address
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Address Line | 4157 MALONE AVE
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City | THE COLONY
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State | TX
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Zip | 75056-3064
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Country | US
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Telephone | 316-613-1929
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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