Provider Demographics
NPI:1972927762
Name:WEBER-WATSON, LAUREL KAY (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAUREL
Middle Name:KAY
Last Name:WEBER-WATSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MS
Other - First Name:LAUREL
Other - Middle Name:KAY
Other - Last Name:WEBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:1606 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47804-2706
Mailing Address - Country:US
Mailing Address - Phone:812-478-4103
Mailing Address - Fax:812-238-7484
Practice Address - Street 1:1606 N 7TH ST
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-2706
Practice Address - Country:US
Practice Address - Phone:812-478-4103
Practice Address - Fax:812-238-7484
Is Sole Proprietor?:No
Enumeration Date:2014-02-13
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22003652A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist