Basic Information
| Provider Information | |||||||||
| NPI: | 1649904418 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCALLORN BRIDGES | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.S., CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6051 FM 3009 STE 215 | ||||||||
| Address2: | |||||||||
| City: | SCHERTZ | ||||||||
| State: | TX | ||||||||
| PostalCode: | 781543473 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8305564480 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1202 E SONTERRA BLVD STE 609 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782584093 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8304206200 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2022 | ||||||||
| LastUpdateDate: | 07/15/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | TX | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.