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General NPI Number Information
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NPI Number | 1265204077
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Entity Type | Organization
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Legal Business Name | LAZZARONI PEDIATRIC SPEECH THERAPY, LLC
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Dates
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Enumeration Date | 10/25/2023
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 566 N INDIANA AVE
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City | CROWN POINT
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State | IN
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Zip | 46307-3412
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Country | US
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Telephone | 219-200-4077
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Fax |
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Provider Business Mailing Address
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Address Line | 14003 SOUTH ANNAPOLIS COURT
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City | CEDAR LAKE
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State | IN
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Zip | 46303
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Country | US
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Telephone | 708-220-2333
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAUREN LAZZARONI
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Credential |
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Telephone | 219-200-4077
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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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