Basic Information
| Provider Information | |||||||||
| NPI: | 1629406830 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TOME | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | CHRISTINE | ||||||||
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| Credential: | SLPA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 646 SW 168TH LN | ||||||||
| Address2: | |||||||||
| City: | PEMBROKE PINES | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330271400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9548492008 | ||||||||
| FaxNumber: | 9546035341 | ||||||||
| Practice Location | |||||||||
| Address1: | 5555 HOLLYWOOD BLVD | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | HOLLYWOOD | ||||||||
| State: | FL | ||||||||
| PostalCode: | 330216476 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9546031881 | ||||||||
| FaxNumber: | 9546035341 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/25/2013 | ||||||||
| LastUpdateDate: | 10/29/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2355S0801X | SI2287 | FL | Y | Speech, Language and Hearing Service Providers | Specialist/Technologist | Speech-Language Assistant |
No ID Information.