Provider Demographics
NPI:1528587169
Name:PEARCE, LAURA KINNEY (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:KINNEY
Last Name:PEARCE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:CAMILLE
Other - Last Name:KINNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CF
Mailing Address - Street 1:6505 SHILOH RD #100
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005
Mailing Address - Country:US
Mailing Address - Phone:770-402-1266
Mailing Address - Fax:
Practice Address - Street 1:6505 SHILOH RD #100
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005
Practice Address - Country:US
Practice Address - Phone:770-402-1266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6289235Z00000X
GASLP010213235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist