Provider Demographics
NPI:1750454401
Name:BERDING, LAURA K (MA,CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:K
Last Name:BERDING
Suffix:
Gender:F
Credentials:MA,CCC-SLP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:L
Other - Last Name:KEYSOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-SLP
Mailing Address - Street 1:5452 BLUESKY DR
Mailing Address - Street 2:UNIT #2
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-6438
Mailing Address - Country:US
Mailing Address - Phone:567-224-0443
Mailing Address - Fax:
Practice Address - Street 1:5452 BLUESKY DR
Practice Address - Street 2:UNIT #2
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-6438
Practice Address - Country:US
Practice Address - Phone:567-224-0443
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP 8340235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist