Provider Demographics
NPI:1598251928
Name:LAURITA, NOELLE ANN (MS CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:NOELLE
Middle Name:ANN
Last Name:LAURITA
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 1:106 NORTON WAY
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-5911
Mailing Address - Country:US
Mailing Address - Phone:908-788-8650
Mailing Address - Fax:
Practice Address - Street 1:466 ROUTE 12
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4107
Practice Address - Country:US
Practice Address - Phone:908-788-8650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00424200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty