Provider Demographics
NPI:1194979021
Name:KOCHON, LAURA A (MA,CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:A
Last Name:KOCHON
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 1:1597 COUNTY ROUTE 213
Mailing Address - Street 2:
Mailing Address - City:ULSTER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12487-5350
Mailing Address - Country:US
Mailing Address - Phone:845-853-6274
Mailing Address - Fax:
Practice Address - Street 1:1597 COUNTY ROUTE 213
Practice Address - Street 2:
Practice Address - City:ULSTER PARK
Practice Address - State:NY
Practice Address - Zip Code:12487-5350
Practice Address - Country:US
Practice Address - Phone:845-853-6274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-05
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013259-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist