Provider Demographics
NPI:1184915969
Name:DELROSE, LAURA NICOLE
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:NICOLE
Last Name:DELROSE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4005 NICHOLSON DR
Mailing Address - Street 2:APT 3409
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-8402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4005 NICHOLSON DR
Practice Address - Street 2:APT 3409
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808-8402
Practice Address - Country:US
Practice Address - Phone:760-413-1171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6438235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist