NPI 1063865194

Lauren Jackson, AUD

Practitioner Audiologist Grand Rapids, MI

Practice location

Address: 655 Kenmoor Ave SE STE a, Grand Rapids, MI 49546-8622
Phone: (616) 575-1212

Registered specialties

Audiologist Primary

Speech, Language and Hearing Service Providers Taxonomy 231H00000X Licence 1601000743 (MI)

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Registry record

NPI: 1063865194
Entity type: Individual
Sex (as registered): Female
NPI issued: 13 Jul 2016
Record last updated: 13 Jul 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.