Basic Information
| Provider Information | |||||||||
| NPI: | 1801949466 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAWSON | ||||||||
| FirstName: | BENJAMIN | ||||||||
| MiddleName: | MAKEHAM | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.S., CCC-SLP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3369 RAMBLEWOOD CT | ||||||||
| Address2: | |||||||||
| City: | SARASOTA | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342373842 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9413630139 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3817 E STATE ROAD 64 | ||||||||
| Address2: | |||||||||
| City: | BRADENTON | ||||||||
| State: | FL | ||||||||
| PostalCode: | 342089041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9417455111 | ||||||||
| FaxNumber: | 9417455667 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2007 | ||||||||
| LastUpdateDate: | 07/09/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 235Z00000X | SA 3069 | FL | Y | Speech, Language and Hearing Service Providers | Speech-Language Pathologist |
No ID Information.