Provider Demographics
NPI:1508173998
Name:STUCKI, LAURIE C (AUD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:C
Last Name:STUCKI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 2ND ST S
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-3708
Mailing Address - Country:US
Mailing Address - Phone:208-385-3620
Mailing Address - Fax:208-385-3621
Practice Address - Street 1:172 2ND ST S
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-3708
Practice Address - Country:US
Practice Address - Phone:208-385-3620
Practice Address - Fax:208-385-3621
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2018-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDAUD-1075231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist