Individual
LAURA M LENZEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
1414 S PARK ST, MADISON, WI 53715-2106
(608) 417-8250
Mailing address
202 S PARK ST, COMPLIANCE MAIL CODE-2433, MADISON, WI 53715-1507
(608) 417-6000
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
1213-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1213-154
SPEECH
WI
05
—
42590300
—
WI
Enumeration date
07/18/2006
Last updated
01/08/2015
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