Provider Demographics
NPI:1386831949
Name:SWIFT BIRD, LAURIE ARLEENE (MS,CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:ARLEENE
Last Name:SWIFT BIRD
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 1:6765 ARCADIA ST
Mailing Address - Street 2:
Mailing Address - City:SUMMERSET
Mailing Address - State:SD
Mailing Address - Zip Code:57718-9282
Mailing Address - Country:US
Mailing Address - Phone:605-721-9064
Mailing Address - Fax:
Practice Address - Street 1:6765 ARCADIA ST
Practice Address - Street 2:
Practice Address - City:SUMMERSET
Practice Address - State:SD
Practice Address - Zip Code:57718-9282
Practice Address - Country:US
Practice Address - Phone:605-721-9064
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD01146675235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist