Provider Demographics
NPI:1861644957
Name:SPENCE, LAURA M (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:M
Last Name:SPENCE
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 1:417 POLK ROAD 184
Mailing Address - Street 2:
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953-8537
Mailing Address - Country:US
Mailing Address - Phone:479-216-9247
Mailing Address - Fax:
Practice Address - Street 1:417 POLK ROAD 184
Practice Address - Street 2:
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953-8537
Practice Address - Country:US
Practice Address - Phone:479-216-9247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSP#P8151235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist