Provider Demographics
NPI:1003386954
Name:BEATTIE, LAURA PREHN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:PREHN
Last Name:BEATTIE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:PREHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7 N SPIRAL VINE CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77381-3742
Mailing Address - Country:US
Mailing Address - Phone:601-744-6171
Mailing Address - Fax:
Practice Address - Street 1:4881 W PANTHER CREEK DR
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-2536
Practice Address - Country:US
Practice Address - Phone:281-615-5475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-03
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116030235Z00000X
TN6590235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist