Provider Demographics
NPI:1891831210
Name:SEIVERD, LAURA BETH (MS CCC SLP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BETH
Last Name:SEIVERD
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 1:2839 LAKE SAXON DR
Mailing Address - Street 2:
Mailing Address - City:LAND O LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:34639-6620
Mailing Address - Country:US
Mailing Address - Phone:813-760-3730
Mailing Address - Fax:813-235-6207
Practice Address - Street 1:2839 LAKE SAXON DR
Practice Address - Street 2:
Practice Address - City:LAND O LAKES
Practice Address - State:FL
Practice Address - Zip Code:34639-6620
Practice Address - Country:US
Practice Address - Phone:813-760-3730
Practice Address - Fax:813-235-6207
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2008-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 5298235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist