Provider Demographics
NPI:1588983183
Name:STEVENSON, LAURA G (AUDIOLOGIST)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:G
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:AUDIOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2000 W UNIVERSITY AVE
Mailing Address - Street 2:AC 104
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47306-1022
Mailing Address - Country:US
Mailing Address - Phone:765-285-8175
Mailing Address - Fax:765-285-5623
Practice Address - Street 1:2000 W UNIVERSITY AVE
Practice Address - Street 2:AC 104
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47306-1022
Practice Address - Country:US
Practice Address - Phone:765-285-8175
Practice Address - Fax:765-285-5623
Is Sole Proprietor?:No
Enumeration Date:2010-05-21
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist