Provider Demographics
NPI:1275083891
Name:PARA, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:PARA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7216 W ETHAN CT
Mailing Address - Street 2:
Mailing Address - City:MONEE
Mailing Address - State:IL
Mailing Address - Zip Code:60449-8402
Mailing Address - Country:US
Mailing Address - Phone:708-906-4953
Mailing Address - Fax:
Practice Address - Street 1:7216 W ETHAN CT
Practice Address - Street 2:
Practice Address - City:MONEE
Practice Address - State:IL
Practice Address - Zip Code:60449-8402
Practice Address - Country:US
Practice Address - Phone:708-906-4953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist