Provider Demographics
NPI:1831759893
Name:EILERS, LAURA JANE (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:JANE
Last Name:EILERS
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 1:6041 E MINERAL DR
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3054
Mailing Address - Country:US
Mailing Address - Phone:720-939-5272
Mailing Address - Fax:
Practice Address - Street 1:6041 E MINERAL DR
Practice Address - Street 2:
Practice Address - City:CENTENNIAL
Practice Address - State:CO
Practice Address - Zip Code:80112-3054
Practice Address - Country:US
Practice Address - Phone:720-939-5272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO241103235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist