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NPI Code Detail

MEDICARE: LAUREN GRUBB CCC-SLP

MEDICARE: LAUREN GRUBB 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
1235Z00000XSpeech-Language Pathologist3555OK

General Provider Information

NPI Number : 1912221169
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN GRUBB CCC-SLP
Provider Business Mailing Address
First Line : 14715 BRISTOL PARK BLVD
Second Line :
City : EDMOND
State : OK
Zip : 73013-1894
Country : US
Telephone Number : 405-840-1686
Fax Number : 405-840-1006
Provider Business Practice Location Address
First Line : 14715 BRISTOL PARK BLVD
Second Line :
City : EDMOND
State : OK
Zip : 73013-1894
Country : US
Telephone Number : 405-840-1686
Fax Number : 405-840-1006
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2010
Last Update Date : 03/17/2010

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Directions to “ LAUREN GRUBB CCC-SLP” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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