Provider Demographics
NPI:1033375373
Name:DEWAARD, LAURA ANN (MS/CCC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ANN
Last Name:DEWAARD
Suffix:
Gender:F
Credentials:MS/CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5912 WATERSCAPE PASS
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-5118
Mailing Address - Country:US
Mailing Address - Phone:205-901-5552
Mailing Address - Fax:
Practice Address - Street 1:3057 LORNA RD
Practice Address - Street 2:SUITE 220
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35216-4514
Practice Address - Country:US
Practice Address - Phone:205-978-9939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2542235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist