Provider Demographics
NPI:1316083504
Name:CHEESMAN, LAURA LUCAS (MS CF SLP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:LUCAS
Last Name:CHEESMAN
Suffix:
Gender:F
Credentials:MS CF SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3537 PARKRIDGE CIR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34243-1444
Mailing Address - Country:US
Mailing Address - Phone:941-351-1484
Mailing Address - Fax:
Practice Address - Street 1:5881 RAND BLVD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-5115
Practice Address - Country:US
Practice Address - Phone:941-925-6319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSZ4063235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist