Provider Demographics
NPI:1760637979
Name:DEAN, LAURI (MS CCC-SLP)
Entity type:Individual
Prefix:
First Name:LAURI
Middle Name:
Last Name:DEAN
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 STUYVESANT OVAL
Mailing Address - Street 2:# 1F
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2232
Mailing Address - Country:US
Mailing Address - Phone:917-301-9742
Mailing Address - Fax:
Practice Address - Street 1:16 STUYVESANT OVAL
Practice Address - Street 2:# 1F
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-2232
Practice Address - Country:US
Practice Address - Phone:917-301-9742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013377-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist