Provider Demographics
NPI:1821232794
Name:FISCHER, LAURA (MACCCSLP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:FISCHER
Suffix:
Gender:F
Credentials:MACCCSLP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:MEYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MACCCSLP
Mailing Address - Street 1:1729 E 31ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-4437
Mailing Address - Country:US
Mailing Address - Phone:718-998-3284
Mailing Address - Fax:
Practice Address - Street 1:1729 E 31ST ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-4437
Practice Address - Country:US
Practice Address - Phone:718-998-3284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002218235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist