Provider Demographics
NPI:1114371374
Name:NORMAN, LAURIE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:
Last Name:NORMAN
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 1:48 KAWAILANI CIR
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-8273
Mailing Address - Country:US
Mailing Address - Phone:734-834-6111
Mailing Address - Fax:
Practice Address - Street 1:48 KAWAILANI CIR
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-8273
Practice Address - Country:US
Practice Address - Phone:734-834-6111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-14
Last Update Date:2016-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI01025839235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1372OtherHAWAII SPEECH AND LANGUAGE LICENSURE
MD01025839OtherAMERICAN SPEECH-LANGUAGE-HEARING ASSOCIATION