Provider Demographics
NPI:1851179055
Name:GIFFORD, LAURA ELAINE (AUD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELAINE
Last Name:GIFFORD
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3050 BUSINESS PARK CIR STE 303
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3588
Mailing Address - Country:US
Mailing Address - Phone:615-448-6745
Mailing Address - Fax:615-756-4483
Practice Address - Street 1:3050 BUSINESS PARK CIR STE 303
Practice Address - Street 2:
Practice Address - City:GOODLETTSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37072-3588
Practice Address - Country:US
Practice Address - Phone:615-448-6745
Practice Address - Fax:615-756-4483
Is Sole Proprietor?:No
Enumeration Date:2023-09-19
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1303231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist