Provider Demographics
NPI:1275546442
Name:SMITH, LAURA E (MA, CCC/SLP-L)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:SMITH
Suffix:
Gender:F
Credentials:MA, CCC/SLP-L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 BIOMEDICAL EDUCATION BLDG
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14214-8016
Mailing Address - Country:US
Mailing Address - Phone:716-829-3980
Mailing Address - Fax:716-829-3974
Practice Address - Street 1:52 BIOMEDICAL EDUCATION BLDG
Practice Address - Street 2:UB SPEECH-LANGUAGE AND HEARING CLINIC
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14214-8016
Practice Address - Country:US
Practice Address - Phone:716-829-5529
Practice Address - Fax:716-829-3974
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014816235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist