Provider Demographics
NPI:1447921044
Name:CHO, LAUREN KOOLIS (SLPA)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:KOOLIS
Last Name:CHO
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:KELLY
Other - Last Name:KOOLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6508 LONETREE BLVD STE 104
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-5885
Mailing Address - Country:US
Mailing Address - Phone:916-287-1914
Mailing Address - Fax:
Practice Address - Street 1:6508 LONETREE BLVD STE 104
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-5885
Practice Address - Country:US
Practice Address - Phone:916-287-1914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA44462355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant