Provider Demographics
NPI:1760515183
Name:SEGAL, LAURIE K (MSPA,CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:K
Last Name:SEGAL
Suffix:
Gender:F
Credentials:MSPA,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 VERMEER DR
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-1525
Mailing Address - Country:US
Mailing Address - Phone:215-752-2329
Mailing Address - Fax:
Practice Address - Street 1:1113 EASTON RD
Practice Address - Street 2:
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1901
Practice Address - Country:US
Practice Address - Phone:215-659-3060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL000384L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist