Provider Demographics
NPI:1295586931
Name:LASPADA, BIANCA NICOLE
Entity type:Individual
Prefix:MISS
First Name:BIANCA
Middle Name:NICOLE
Last Name:LASPADA
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 1:2922 HOWARD AVENUE
Mailing Address - Street 2:UNIT D (REAR)
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-1901
Mailing Address - Country:US
Mailing Address - Phone:609-504-7895
Mailing Address - Fax:843-712-1580
Practice Address - Street 1:2922 HOWARD AVENUE
Practice Address - Street 2:UNIT D (REAR)
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-1901
Practice Address - Country:US
Practice Address - Phone:609-504-7895
Practice Address - Fax:843-712-1580
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist