Provider Demographics
NPI:1770119026
Name:SLOCUM, LAURA ELAINE (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ELAINE
Last Name:SLOCUM
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 WOODHAVEN PL
Mailing Address - Street 2:
Mailing Address - City:OBERLIN
Mailing Address - State:OH
Mailing Address - Zip Code:44074-1449
Mailing Address - Country:US
Mailing Address - Phone:614-668-7341
Mailing Address - Fax:
Practice Address - Street 1:118 WOODHAVEN PL
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:OH
Practice Address - Zip Code:44074-1449
Practice Address - Country:US
Practice Address - Phone:614-668-7341
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-19
Last Update Date:2020-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.07840235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist