Provider Demographics
NPI:1619006244
Name:EAKINS, LAURA LYNELLE
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNELLE
Last Name:EAKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 N 4TH AVE
Mailing Address - Street 2:SPECIAL SERVICES -- PO BOX 166
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-6656
Mailing Address - Country:US
Mailing Address - Phone:417-582-5900
Mailing Address - Fax:
Practice Address - Street 1:302 N 4TH AVE
Practice Address - Street 2:SPECIAL SERVICES
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-6656
Practice Address - Country:US
Practice Address - Phone:417-582-5900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000163861235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist