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General NPI Number Information
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NPI Number | 1902698541
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Entity Type | Individual
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Provider Name | LAUREN TREJO
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Gender | Female
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 9191 R G SKINNER PKWY UNIT 103
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City | JACKSONVILLE
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State | FL
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Zip | 32256-9656
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Country | US
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Telephone | 904-428-8302
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Fax |
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Provider Business Mailing Address
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Address Line | 4020 GREAT BLUE HERON WAY
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City | JACKSONVILLE
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State | FL
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Zip | 32217-3723
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Country | US
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Telephone | 661-992-4354
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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 | 23407
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License Number State | FL
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