Provider Demographics
NPI:1093803173
Name:NABOURS, LAURA THERESE (MA CCCSLP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:THERESE
Last Name:NABOURS
Suffix:
Gender:F
Credentials:MA CCCSLP
Other - Prefix:MRS
Other - First Name:LAURA
Other - Middle Name:THERESE
Other - Last Name:SNYDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:207 MERRITT DRIVE
Mailing Address - Street 2:
Mailing Address - City:LA VERGNE
Mailing Address - State:TN
Mailing Address - Zip Code:37086
Mailing Address - Country:US
Mailing Address - Phone:615-213-2263
Mailing Address - Fax:615-793-2213
Practice Address - Street 1:300 STONECREST BLVD SUITE 375
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167
Practice Address - Country:US
Practice Address - Phone:615-220-5798
Practice Address - Fax:615-220-8829
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2035235Z00000X
NM1049235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4114436OtherBCBS