Provider Demographics
NPI:1386386076
Name:HARO, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:HARO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11706 HERITAGE POINT DR APT 111
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32825-5057
Mailing Address - Country:US
Mailing Address - Phone:239-384-1674
Mailing Address - Fax:
Practice Address - Street 1:5165 ADANSON ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-1331
Practice Address - Country:US
Practice Address - Phone:352-394-0212
Practice Address - Fax:352-241-6361
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-12
Last Update Date:2022-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA18639235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist