Provider Demographics
NPI:1013417260
Name:STRUEBY, LAURIE (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:STRUEBY
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 BROOKVALLEY DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76018-2960
Mailing Address - Country:US
Mailing Address - Phone:817-487-2515
Mailing Address - Fax:
Practice Address - Street 1:9240 COUNTY VIEW RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75249-1124
Practice Address - Country:US
Practice Address - Phone:972-708-2060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-14
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
TX15173235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No251E00000XAgenciesHome Health