Provider Demographics
NPI:1457734972
Name:HARRIS, LAURA BETH (MA, CCC/SLP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:BETH
Last Name:HARRIS
Suffix:
Gender:F
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 CANDLELIGHT CT
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-5202
Mailing Address - Country:US
Mailing Address - Phone:540-313-0150
Mailing Address - Fax:
Practice Address - Street 1:7047 EMMA AVE
Practice Address - Street 2:
Practice Address - City:JENNINGS
Practice Address - State:MO
Practice Address - Zip Code:63136-1099
Practice Address - Country:US
Practice Address - Phone:314-653-8070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202007546235Z00000X
MO2005002437235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist