Provider Demographics
NPI:1427484906
Name:SUMMERS, LAURA TALLEY (M A CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:TALLEY
Last Name:SUMMERS
Suffix:
Gender:F
Credentials:M A CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 FLORIDA ST
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-3842
Mailing Address - Country:US
Mailing Address - Phone:225-381-6527
Mailing Address - Fax:
Practice Address - Street 1:3600 FLORIDA ST
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-3842
Practice Address - Country:US
Practice Address - Phone:225-381-6527
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-17
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA2601235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist