Provider Demographics
NPI:1588861975
Name:HART, LAURA J (MS CCC SLP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:J
Last Name:HART
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:J
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 PARKERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-3725
Mailing Address - Country:US
Mailing Address - Phone:978-455-6075
Mailing Address - Fax:
Practice Address - Street 1:50 PARKERVILLE RD
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-3725
Practice Address - Country:US
Practice Address - Phone:978-455-6075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA6491235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist