Individual
LAUREN LOUISE BEAULIEU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
34 W 500 S, JEROME, ID 83338-5957
(208) 324-7117
Mailing address
34 W 500 S, JEROME, ID 83338-5957
(208) 324-7117
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP-1116
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
808103800
—
ID
01
—
SP051
BLUE CROSS OF IDAHO
ID
Enumeration date
05/27/2008
Last updated
09/23/2008
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