Provider Demographics
NPI:1952550261
Name:PACINI, LAURA JEANNE (AUD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:JEANNE
Last Name:PACINI
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 N 2ND E STE 3
Mailing Address - Street 2:
Mailing Address - City:REXBURG
Mailing Address - State:ID
Mailing Address - Zip Code:83440-1638
Mailing Address - Country:US
Mailing Address - Phone:208-356-0766
Mailing Address - Fax:
Practice Address - Street 1:256 N 2ND E STE 3
Practice Address - Street 2:
Practice Address - City:REXBURG
Practice Address - State:ID
Practice Address - Zip Code:83440-1638
Practice Address - Country:US
Practice Address - Phone:208-356-0766
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-10
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA.01663231H00000X, 237600000X
IDAUD-5912231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter