Provider Demographics
NPI:1013496280
Name:ESTEPP, LAURA LEE (SLP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:ESTEPP
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3332 BLUEBIRD RDG
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2681
Mailing Address - Country:US
Mailing Address - Phone:575-430-3667
Mailing Address - Fax:
Practice Address - Street 1:4553 N LOOP 1604 W STE 1119
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-1364
Practice Address - Country:US
Practice Address - Phone:210-698-9844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110466235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist