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NPI Code Detail

MEDICARE: LAUREN BERRY SLP

MEDICARE:   LAUREN  BERRY  SLP
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
1235Z00000XSpeech-Language PathologistS-4607MS

General Provider Information

NPI Number : 1659119188
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN BERRY SLP
Provider Business Mailing Address
First Line : 792 WHITE RD
Second Line :
City : FLORENCE
State : MS
Zip : 39073-9681
Country : US
Telephone Number : 601-405-5394
Fax Number :
Provider Business Practice Location Address
First Line : 500 SILVER CROSS DR STE A
Second Line :
City : BROOKHAVEN
State : MS
Zip : 39601-2304
Country : US
Telephone Number : 601-757-7787
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2024
Last Update Date : 07/18/2024

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Directions to “ LAUREN BERRY SLP” Practice Location

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