Provider Demographics
NPI:1205024973
Name:HEALEY-STARR, LAURIE LEE (MS, CCC-SLP ( C ))
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:LEE
Last Name:HEALEY-STARR
Suffix:
Gender:F
Credentials:MS, CCC-SLP ( C )
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 LAUREL LAKE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:NC
Mailing Address - Zip Code:28722-7451
Mailing Address - Country:US
Mailing Address - Phone:321-432-2166
Mailing Address - Fax:
Practice Address - Street 1:619 LAUREL LAKE DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-7451
Practice Address - Country:US
Practice Address - Phone:828-894-3895
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7169235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist