Provider Demographics
NPI:1861152928
Name:LAURA, KARIN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:KARIN
Middle Name:
Last Name:LAURA
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 1:45 FERNALD XING
Mailing Address - Street 2:
Mailing Address - City:WOLFEBORO
Mailing Address - State:NH
Mailing Address - Zip Code:03894-4920
Mailing Address - Country:US
Mailing Address - Phone:407-687-5552
Mailing Address - Fax:
Practice Address - Street 1:76 WINTER ST
Practice Address - Street 2:
Practice Address - City:TILTON
Practice Address - State:NH
Practice Address - Zip Code:03276-5411
Practice Address - Country:US
Practice Address - Phone:603-286-7143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-29
Last Update Date:2021-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2168235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist