Provider Demographics
NPI:1003068750
Name:TUTEN, LAURIE ELIZABETH (CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:ELIZABETH
Last Name:TUTEN
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:603 E GIRARD AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19125-3408
Mailing Address - Country:US
Mailing Address - Phone:215-584-1194
Mailing Address - Fax:
Practice Address - Street 1:603 E GIRARD AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19125-3408
Practice Address - Country:US
Practice Address - Phone:215-584-1194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL008650235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist