Provider Demographics
NPI:1528241783
Name:REISINGER, LAURA L
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:L
Last Name:REISINGER
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 1:5425 EVENING MIST DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TN
Mailing Address - Zip Code:38002-5016
Mailing Address - Country:US
Mailing Address - Phone:901-230-2926
Mailing Address - Fax:
Practice Address - Street 1:5425 EVENING MIST DR
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TN
Practice Address - Zip Code:38002-5016
Practice Address - Country:US
Practice Address - Phone:901-230-2926
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000002679235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist