Provider Demographics
NPI:1144575580
Name:KNOTT-RIGGALL, LAURA LEIGH (CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LEIGH
Last Name:KNOTT-RIGGALL
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 1:283 RED HAWK WAY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30132-1149
Mailing Address - Country:US
Mailing Address - Phone:561-801-3148
Mailing Address - Fax:
Practice Address - Street 1:283 RED HAWK WAY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:GA
Practice Address - Zip Code:30132-1149
Practice Address - Country:US
Practice Address - Phone:561-801-3148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-23
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP007396235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist