Provider Demographics
NPI:1003040866
Name:MIKKOLA, LAURA S (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:S
Last Name:MIKKOLA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:S
Other - Last Name:L'HEUREUX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS CCC-SLP
Mailing Address - Street 1:103 FREHOLD CT
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27519-7372
Mailing Address - Country:US
Mailing Address - Phone:919-465-4424
Mailing Address - Fax:919-465-4427
Practice Address - Street 1:103 FREHOLD CT
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27519-7372
Practice Address - Country:US
Practice Address - Phone:919-465-4424
Practice Address - Fax:919-465-4427
Is Sole Proprietor?:No
Enumeration Date:2009-05-08
Last Update Date:2013-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC8248235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist