Provider Demographics
NPI:1619281128
Name:SPEARS, LAURA MONTS (MSP CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MONTS
Last Name:SPEARS
Suffix:
Gender:F
Credentials:MSP CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 SC HIGHWAY 391
Mailing Address - Street 2:
Mailing Address - City:PROSPERITY
Mailing Address - State:SC
Mailing Address - Zip Code:29127-7470
Mailing Address - Country:US
Mailing Address - Phone:803-318-1583
Mailing Address - Fax:803-364-4855
Practice Address - Street 1:520 MAIN ST
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:SC
Practice Address - Zip Code:29054-8441
Practice Address - Country:US
Practice Address - Phone:803-821-1400
Practice Address - Fax:803-364-4855
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4662235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist