Provider Demographics
NPI:1841597788
Name:VALENZUELA, LAURA (MS CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:VALENZUELA
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 W APRIL BLOSSOMS PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85737-8801
Mailing Address - Country:US
Mailing Address - Phone:520-247-4135
Mailing Address - Fax:
Practice Address - Street 1:1020 S HARRISON RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85748-6610
Practice Address - Country:US
Practice Address - Phone:520-721-1887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-02-11
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP7152235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist