Provider Demographics
NPI:1609138635
Name:FITZGERALD, LAURA SCOTT (MA)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:SCOTT
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7578 E TAILSPIN LN
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-4633
Mailing Address - Country:US
Mailing Address - Phone:480-513-2303
Mailing Address - Fax:
Practice Address - Street 1:7578 E TAILSPIN LN
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-4633
Practice Address - Country:US
Practice Address - Phone:480-513-2303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2012-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP#6134235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist