Provider Demographics
NPI:1376624205
Name:ZIMMERMAN, LAURA L (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:L
Last Name:ZIMMERMAN
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6619 TWIN LEAF
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379
Mailing Address - Country:US
Mailing Address - Phone:281-257-6714
Mailing Address - Fax:281-288-1081
Practice Address - Street 1:19627 I45 NORTH
Practice Address - Street 2:SUITE 105
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77388
Practice Address - Country:US
Practice Address - Phone:281-257-6714
Practice Address - Fax:281-288-1081
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100994235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist