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General NPI Number Information
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NPI Number | 1710309596
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Entity Type | Individual
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Provider Name | LAUREN E BALLE MS CF SLP
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Gender | Female
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Dates
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Enumeration Date | 01/13/2014
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Last Update Date | 01/13/2014
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Provider Practice Location Address
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Address Line | 5968 CLARK CENTER AVE
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City | SARASOTA
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State | FL
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Zip | 34238-2715
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Country | US
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Telephone | 941-922-8200
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Fax | 941-343-9402
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Provider Business Mailing Address
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Address Line | 4232 53RD AVE W APT 2507
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City | BRADENTON
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State | FL
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Zip | 34210-4410
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Country | US
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Telephone | 941-807-6278
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Fax | 941-343-9402
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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 | SA12740
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License Number State | FL
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