Provider Demographics
NPI:1184671695
Name:SIEGEL, LAURA REISLER (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:REISLER
Last Name:SIEGEL
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6902 CAMERON CREST CIR APT 121
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-7348
Mailing Address - Country:US
Mailing Address - Phone:917-509-9616
Mailing Address - Fax:
Practice Address - Street 1:6902 CAMERON CREST CIR APT 121
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-7348
Practice Address - Country:US
Practice Address - Phone:917-572-7280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-28
Last Update Date:2025-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002811235Z00000X
NC30003375235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist