Provider Demographics
NPI:1164766317
Name:SMITH, LAURA KAY (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:KAY
Last Name:SMITH
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 1:15611 E CASPIAN CIR APT 302
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80013-6306
Mailing Address - Country:US
Mailing Address - Phone:720-480-4977
Mailing Address - Fax:
Practice Address - Street 1:15611 E CASPIAN CIR APT 302
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80013-6306
Practice Address - Country:US
Practice Address - Phone:720-480-4977
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-11
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO17679235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist