Provider Demographics
NPI:1033740543
Name:SCHUBERT, LAURAMARIE ANDRES (SLP)
Entity Type:Individual
Prefix:
First Name:LAURAMARIE
Middle Name:ANDRES
Last Name:SCHUBERT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:LAURAMARIE
Other - Middle Name:
Other - Last Name:BELCHAK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:100 MICHIGAN ST NE # MC845
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503-2560
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:35 MICHIGN ST NE STE 3003
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-2528
Practice Address - Country:US
Practice Address - Phone:616-267-2200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-03
Last Update Date:2020-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101000244235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist