Provider Demographics
NPI:1063700052
Name:HAIBECK, LAURA (MS)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:HAIBECK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 PENN AVE
Mailing Address - Street 2:THIRD FLOOR, ALLIGATOR
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-1334
Mailing Address - Country:US
Mailing Address - Phone:412-692-7655
Mailing Address - Fax:412-692-5563
Practice Address - Street 1:4401 PENN AVE
Practice Address - Street 2:THIRD FLOOR, ALLIGATOR
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-1334
Practice Address - Country:US
Practice Address - Phone:412-692-7655
Practice Address - Fax:412-692-5563
Is Sole Proprietor?:No
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL003755L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist