Provider Demographics
NPI:1225192271
Name:CIZEK, LAURA SUZANNE (CCC-SLP)
Entity Type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:SUZANNE
Last Name:CIZEK
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 CLINICAL RESEARCH CTR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77204-6018
Mailing Address - Country:US
Mailing Address - Phone:713-143-2898
Mailing Address - Fax:713-743-2926
Practice Address - Street 1:100 CLINICAL RESEARCH CTR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77204-6018
Practice Address - Country:US
Practice Address - Phone:713-143-2898
Practice Address - Fax:713-743-2926
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19533235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist