Provider Demographics
NPI:1801045166
Name:GIROUARD, LAURA MARY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:MARY
Last Name:GIROUARD
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
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Mailing Address - Street 1:812 N LOGAN ST C/O REHAB-SPEECH PATHOLOGY
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832
Mailing Address - Country:US
Mailing Address - Phone:217-443-5276
Mailing Address - Fax:217-443-5634
Practice Address - Street 1:2001 S OAK ST
Practice Address - Street 2:SUITE B
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-0906
Practice Address - Country:US
Practice Address - Phone:217-333-2205
Practice Address - Fax:217-333-2206
Is Sole Proprietor?:No
Enumeration Date:2008-09-11
Last Update Date:2012-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL146.008811235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist