Provider Demographics
NPI:1043440670
Name:ADAMSON, LAURA C (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:C
Last Name:ADAMSON
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 WESTERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52806-4043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5403 VICTORIA AVE
Practice Address - Street 2:SUITE 20
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-3925
Practice Address - Country:US
Practice Address - Phone:563-327-0133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-16
Last Update Date:2011-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001980235Z00000X
IL146010277235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist