MEDICARE: SHEA LAURREN URIE

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	12753391-4102	UT

General Provider Information

NPI Number	:	1568312973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEA LAURREN URIE

Provider Business Mailing Address
First Line	:	1175 CANYON RD APT 23
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84404-5946
Country	:	US
Telephone Number	:	801-903-3508
Fax Number	:

Provider Business Practice Location Address
First Line	:	1175 CANYON RD APT 23
Second Line	:
City	:	OGDEN
State	:	UT
Zip	:	84404-5946
Country	:	US
Telephone Number	:	801-903-3508
Fax Number	:

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

Provider Enumeration Date	:	02/03/2026
Last Update Date	:	02/03/2026

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Directions to “ SHEA LAURREN URIE ” Practice Location

Language	Start Address	Practice Location

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