MEDICARE: LAUREN BRASSFIELD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	5646	TN

General Provider Information

NPI Number	:	1225589724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN BRASSFIELD

Provider Business Mailing Address
First Line	:	1105 FREWIN ST
Second Line	:
City	:	NOLENSVILLE
State	:	TN
Zip	:	37135-0628
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1173 ROCK SPRINGS RD
Second Line	:	SUITE 105
City	:	SMYRNA
State	:	TN
Zip	:	37167-8413
Country	:	US
Telephone Number	:	615-220-5796
Fax Number	:	615-220-8829

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2016
Last Update Date	:	10/19/2016

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Directions to “ LAUREN BRASSFIELD ” Practice Location

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