Provider Demographics
NPI:1497507941
Name:GAUDETTE, LAURA M (MS CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:GAUDETTE
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 1:5250 S PICADILLY ST
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80015-3300
Mailing Address - Country:US
Mailing Address - Phone:720-886-1500
Mailing Address - Fax:
Practice Address - Street 1:5250 S PICADILLY ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-3300
Practice Address - Country:US
Practice Address - Phone:720-886-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA14308501235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist