Provider Demographics
NPI:1225404262
Name:SUOR, LAUREL (MA)
Entity Type:Individual
Prefix:
First Name:LAUREL
Middle Name:
Last Name:SUOR
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3123 PARKWAY
Mailing Address - Street 2:
Mailing Address - City:CHEVERLY
Mailing Address - State:MD
Mailing Address - Zip Code:20785-1256
Mailing Address - Country:US
Mailing Address - Phone:301-232-0600
Mailing Address - Fax:
Practice Address - Street 1:3123 PARKWAY
Practice Address - Street 2:
Practice Address - City:CHEVERLY
Practice Address - State:MD
Practice Address - Zip Code:20785-1256
Practice Address - Country:US
Practice Address - Phone:301-232-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-13
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12092235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist