Provider Demographics
NPI:1891371522
Name:ZAWALICH, LAURA MCBRIDE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:MCBRIDE
Last Name:ZAWALICH
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 1:90 SUMMER ST
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-1826
Mailing Address - Country:US
Mailing Address - Phone:978-500-4452
Mailing Address - Fax:
Practice Address - Street 1:203 TURNPIKE ST STE G3
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5042
Practice Address - Country:US
Practice Address - Phone:978-794-1899
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2022-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
14356139235Z00000X
MA77876235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist