Provider Demographics
NPI:1992559181
Name:ARSENEAULT, LAURA LYNN (MA, CCC-SLP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:ARSENEAULT
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LYNN
Other - Last Name:RABE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55297 DEMARET DR
Mailing Address - Street 2:
Mailing Address - City:MACOMB
Mailing Address - State:MI
Mailing Address - Zip Code:48042-1212
Mailing Address - Country:US
Mailing Address - Phone:586-243-0566
Mailing Address - Fax:
Practice Address - Street 1:34643 KETSIN DR
Practice Address - Street 2:
Practice Address - City:STERLING HTS
Practice Address - State:MI
Practice Address - Zip Code:48310-5235
Practice Address - Country:US
Practice Address - Phone:586-600-8009
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7101006138235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist