Provider Demographics
NPI:1194733295
Name:LOVELESS, LAURA HARMON (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:HARMON
Last Name:LOVELESS
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4301 FOREMAN TRL
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23456-8015
Mailing Address - Country:US
Mailing Address - Phone:757-447-3463
Mailing Address - Fax:757-447-3462
Practice Address - Street 1:4301 FOREMAN TRL
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-8015
Practice Address - Country:US
Practice Address - Phone:757-447-3463
Practice Address - Fax:757-447-3462
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2011-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202006220235Z00000X
CT4040235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist