Provider Demographics
NPI:1700098704
Name:SALOME, LAURA ELIZABETH (AUD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELIZABETH
Last Name:SALOME
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:ELIZABETH
Other - Last Name:PAPA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3136 PINE BLFS
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48357-4249
Mailing Address - Country:US
Mailing Address - Phone:845-781-0969
Mailing Address - Fax:
Practice Address - Street 1:1225 S LATSON RD
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-7643
Practice Address - Country:US
Practice Address - Phone:810-494-4327
Practice Address - Fax:810-494-4329
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1601000167231H00000X
MI231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist