Provider Demographics
NPI:1164241352
Name:PIERSZA, LAUREN HOLT (SLP)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:HOLT
Last Name:PIERSZA
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3426 MARLINSPIKE DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-5856
Mailing Address - Country:US
Mailing Address - Phone:904-671-2705
Mailing Address - Fax:
Practice Address - Street 1:2111 W SWANN AVE STE 100
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33606-2478
Practice Address - Country:US
Practice Address - Phone:813-251-1618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist