Provider Demographics
NPI:1841546181
Name:MRUGALSKI, LAURA J (CCC-SLP, TSSLD, MA)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:J
Last Name:MRUGALSKI
Suffix:
Gender:F
Credentials:CCC-SLP, TSSLD, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:164 TRENTON AVE
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10606-2014
Mailing Address - Country:US
Mailing Address - Phone:914-320-7214
Mailing Address - Fax:
Practice Address - Street 1:555 KNOLLWOOD RD
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-1928
Practice Address - Country:US
Practice Address - Phone:914-949-1710
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-24
Last Update Date:2012-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017664-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist