Provider Demographics
NPI:1053948745
Name:WRIGHT, LAUREN CAVALLARO (SLP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:CAVALLARO
Last Name:WRIGHT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4739 STONEY TRCE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-2593
Mailing Address - Country:US
Mailing Address - Phone:850-694-0534
Mailing Address - Fax:
Practice Address - Street 1:4739 STONEY TRCE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32309-2593
Practice Address - Country:US
Practice Address - Phone:850-694-0534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2024-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
235Z00000X
FLSA15541235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist