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Individual

LAUREN ELIZABETH O'LEARY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, CCC-SLP

Contact information

Practice address
5800 RIDGE AVENUE, PHILADELPHIA, PA 19128-1912
(215) 487-4734
(215) 487-4328
Mailing address
230 JAMESTOWN ST, PHILADELPHIA, PA 19128-5004
(908) 268-4344

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL012922
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14066252
ASHA
PA
01
SL012922
STATE LICENSE TO PRACTICE
PA
Enumeration date
05/07/2019
Last updated
05/07/2019
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