Provider Demographics
NPI:1043572043
Name:GUEST, LAURA BETH (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BETH
Last Name:GUEST
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 1:1090 ROBINSON CT
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30606-7063
Mailing Address - Country:US
Mailing Address - Phone:478-972-7941
Mailing Address - Fax:
Practice Address - Street 1:1090 ROBINSON CT
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30606-7063
Practice Address - Country:US
Practice Address - Phone:478-972-7941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007691235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist