Provider Demographics
NPI:1417105271
Name:ACKERMAN, LAURA BETH (MA CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:BETH
Last Name:ACKERMAN
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2625 ANITA DR.
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75041
Mailing Address - Country:US
Mailing Address - Phone:972-926-2671
Mailing Address - Fax:972-926-2679
Practice Address - Street 1:2625 ANITA DR.
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75041
Practice Address - Country:US
Practice Address - Phone:972-926-2671
Practice Address - Fax:972-926-2679
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2008-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14936235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist