Provider Demographics
NPI:1356395057
Name:CAIRNS, LAURA MARIE (CCC/SLP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:CAIRNS
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:833 WAKE FOREST BUISENSS PK
Mailing Address - Street 2:SUITE D
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587
Mailing Address - Country:US
Mailing Address - Phone:919-556-1700
Mailing Address - Fax:919-556-1245
Practice Address - Street 1:833 WAKE FOREST BUSINESS PARK
Practice Address - Street 2:SUITE D
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-6523
Practice Address - Country:US
Practice Address - Phone:919-556-1700
Practice Address - Fax:919-556-1245
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2949235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7420665Medicaid
NC20665OtherBCBS