Provider Demographics
NPI:1083213276
Name:SWENSON, LAURA (SLP)
Entity Type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:
Last Name:SWENSON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1922 STATE ROAD 87
Mailing Address - Street 2:
Mailing Address - City:SAINT CROIX FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54024-7937
Mailing Address - Country:US
Mailing Address - Phone:715-501-0120
Mailing Address - Fax:
Practice Address - Street 1:1922 STATE ROAD 87
Practice Address - Street 2:
Practice Address - City:SAINT CROIX FALLS
Practice Address - State:WI
Practice Address - Zip Code:54024-7937
Practice Address - Country:US
Practice Address - Phone:715-501-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist