Provider Demographics
NPI:1104171495
Name:COOK, LAURA ASHLEY (SLPA)
Entity type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:ASHLEY
Last Name:COOK
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16121 E BALSAM DR
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN HILLS
Mailing Address - State:AZ
Mailing Address - Zip Code:85268-2216
Mailing Address - Country:US
Mailing Address - Phone:480-390-7194
Mailing Address - Fax:
Practice Address - Street 1:16121 E BALSAM DR
Practice Address - Street 2:
Practice Address - City:FOUNTAIN HILLS
Practice Address - State:AZ
Practice Address - Zip Code:85268-2216
Practice Address - Country:US
Practice Address - Phone:480-390-7194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-23
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA77382355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant