Provider Demographics
NPI:1760576326
Name:ORTMANN, LAURA A (MS, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:A
Last Name:ORTMANN
Suffix:
Gender:F
Credentials:MS, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:457 ENGLAND DR
Mailing Address - Street 2:
Mailing Address - City:FESTUS
Mailing Address - State:MO
Mailing Address - Zip Code:63028-2623
Mailing Address - Country:US
Mailing Address - Phone:314-523-5395
Mailing Address - Fax:
Practice Address - Street 1:226 S WOODS MILL RD STE 37W
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3442
Practice Address - Country:US
Practice Address - Phone:314-523-5395
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2008-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001002812231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000021583Medicare ID - Type Unspecified