Basic Information
| Provider Information | |||||||||
| NPI: | 1750414124 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MAMMONE | ||||||||
| FirstName: | LAUREN | ||||||||
| MiddleName: | RAE | ||||||||
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| Credential: | MS CCC SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9 MARIE DR | ||||||||
| Address2: | |||||||||
| City: | CHARLEROI | ||||||||
| State: | PA | ||||||||
| PostalCode: | 150223324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7246011843 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1717 SKYLINE DR | ||||||||
| Address2: | |||||||||
| City: | PITTSBURGH | ||||||||
| State: | PA | ||||||||
| PostalCode: | 152271616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4128858400 | ||||||||
| FaxNumber: | 4128822853 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SL008040 | PA | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.