Provider Demographics
NPI:1497977953
Name:TEENOR, LAURA JENNIFER (MA, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:JENNIFER
Last Name:TEENOR
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:JENNIFER
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:2724 LARKSPUR CT
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66047-3351
Mailing Address - Country:US
Mailing Address - Phone:785-766-3421
Mailing Address - Fax:
Practice Address - Street 1:2724 LARKSPUR CT
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-3351
Practice Address - Country:US
Practice Address - Phone:785-766-3421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1160235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist