Basic Information
| Provider Information | |||||||||
| NPI: | 1720539596 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARRIGUS | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | ANNE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 43279 SCHOENHERR RD | ||||||||
| Address2: | |||||||||
| City: | STERLING HEIGHTS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483131957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3132784601 | ||||||||
| FaxNumber: | 3133471652 | ||||||||
| Practice Location | |||||||||
| Address1: | 43279 SCHOENHERR RD | ||||||||
| Address2: | |||||||||
| City: | STERLING HEIGHTS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483131957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3132784601 | ||||||||
| FaxNumber: | 3133471652 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/17/2016 | ||||||||
| LastUpdateDate: | 05/24/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/24/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 247200000X | N | Technologists, Technicians & Other Technical Service Providers | Technician, Other | 235Z00000X | 7152000301 | MI | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.