Provider Demographics
NPI:1972660314
Name:MOUNT, LAURA C (AUD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:C
Last Name:MOUNT
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 CORLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BOAZ
Mailing Address - State:AL
Mailing Address - Zip Code:35957-5952
Mailing Address - Country:US
Mailing Address - Phone:256-571-8450
Mailing Address - Fax:256-571-8450
Practice Address - Street 1:602 CORLEY AVE
Practice Address - Street 2:
Practice Address - City:BOAZ
Practice Address - State:AL
Practice Address - Zip Code:35957-5952
Practice Address - Country:US
Practice Address - Phone:256-571-8450
Practice Address - Fax:256-840-4584
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU2255231H00000X
CAHA5047237600000X
237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist