Provider Demographics
NPI:1790523330
Name:SAUVAGE, LAURELINE (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:LAURELINE
Middle Name:
Last Name:SAUVAGE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 S KING ST STE B4
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-1700
Mailing Address - Country:US
Mailing Address - Phone:808-593-0030
Mailing Address - Fax:
Practice Address - Street 1:1010 S KING ST STE B4
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-1700
Practice Address - Country:US
Practice Address - Phone:808-593-0030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-17
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HISP-2328235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist