Individual
LAUREN MARIE RENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
490 HIGHWAY 96 W, SUITE 300, SHOREVIEW, MN 55126-1960
(651) 451-3016
(651) 481-7840
Mailing address
5391 CARLSON RD, SHOREVIEW, MN 55126-1214
(314) 591-9348
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
PENDING
MN
Other
Enumeration date
01/25/2011
Last updated
01/25/2011
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