Provider Demographics
NPI:1992020317
Name:BUIS, LAURA DANIELLE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:DANIELLE
Last Name:BUIS
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 SILVERCREEK DR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40422-2907
Mailing Address - Country:US
Mailing Address - Phone:606-706-6219
Mailing Address - Fax:
Practice Address - Street 1:108 SILVERCREEK DR
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:KY
Practice Address - Zip Code:40422-2907
Practice Address - Country:US
Practice Address - Phone:606-706-6219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY09-071235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist