Provider Demographics
NPI:1942577762
Name:VERA, LAUREL LEE (MS)
Entity Type:Individual
Prefix:MRS
First Name:LAUREL
Middle Name:LEE
Last Name:VERA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7143 SHREVE RD
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22043-3011
Mailing Address - Country:US
Mailing Address - Phone:703-237-2219
Mailing Address - Fax:703-237-2729
Practice Address - Street 1:7143 SHREVE RD
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-3011
Practice Address - Country:US
Practice Address - Phone:703-237-2219
Practice Address - Fax:703-237-2729
Is Sole Proprietor?:No
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202000670235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist