Provider Demographics
NPI:1114284510
Name:STEARNS, LAURA J (MA CCC/SLP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:J
Last Name:STEARNS
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 1:5943 TREELEDGE DR
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-6123
Mailing Address - Country:US
Mailing Address - Phone:719-535-9178
Mailing Address - Fax:
Practice Address - Street 1:1605 ELM CREEK VW
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-7181
Practice Address - Country:US
Practice Address - Phone:719-633-8181
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-23
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01133735OtherASHA