MEDICARE: LAUREN WERNER M.A. CCC-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
1	235Z00000X	Speech-Language Pathologist	7101003501	MI
2	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1801142278
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN WERNER M.A. CCC-SLP

Provider Business Mailing Address
First Line	:	18501 ROTUNDA DR
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-3891
Country	:	US
Telephone Number	:	313-996-1951
Fax Number	:

Provider Business Practice Location Address
First Line	:	18501 ROTUNDA DR
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48124-3891
Country	:	US
Telephone Number	:	313-996-1951
Fax Number	:

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

Provider Enumeration Date	:	08/03/2012
Last Update Date	:	10/30/2018

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Directions to “ LAUREN WERNER M.A. CCC-SLP” Practice Location

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