Provider Demographics
NPI:1457639940
Name:GARRETT, LAURA LYNN (CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LYNN
Last Name:GARRETT
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9758 LAREDO ST
Mailing Address - Street 2:UNIT 36 B
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-9803
Mailing Address - Country:US
Mailing Address - Phone:501-590-1770
Mailing Address - Fax:
Practice Address - Street 1:9758 LAREDO ST
Practice Address - Street 2:UNIT 36 B
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-9803
Practice Address - Country:US
Practice Address - Phone:501-590-1770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
12119434235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist