Provider Demographics
NPI:1063530152
Name:GRAFF, LAURA LYNN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:GRAFF
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 1:6916 LIPSCOMB DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28412-3152
Mailing Address - Country:US
Mailing Address - Phone:910-232-3412
Mailing Address - Fax:
Practice Address - Street 1:6916 LIPSCOMB DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28412-3152
Practice Address - Country:US
Practice Address - Phone:910-232-3412
Practice Address - Fax:910-790-6640
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2011-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC7211235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist