Provider Demographics
NPI:1114333820
Name:GAUVIN, LAURAROSE (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:LAURAROSE
Middle Name:
Last Name:GAUVIN
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 SMITHFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-3820
Mailing Address - Country:US
Mailing Address - Phone:401-353-6300
Mailing Address - Fax:
Practice Address - Street 1:610 SMITHFIELD RD
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-3820
Practice Address - Country:US
Practice Address - Phone:401-353-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP00294-P235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist