MEDICARE: LAUREN JADE GREGORY

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	PSLP0001541	CO

General Provider Information

NPI Number	:	1497699029
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN JADE GREGORY

Provider Business Mailing Address
First Line	:	8099 MEADOW SPRINGS PL
Second Line	:
City	:	STOKESDALE
State	:	NC
Zip	:	27357-7808
Country	:	US
Telephone Number	:	336-601-0652
Fax Number	:

Provider Business Practice Location Address
First Line	:	126 W D ST STE 100C
Second Line	:
City	:	PUEBLO
State	:	CO
Zip	:	81003-4430
Country	:	US
Telephone Number	:	719-621-1182
Fax Number	:

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

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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Directions to “ LAUREN JADE GREGORY ” Practice Location

Language	Start Address	Practice Location

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