MEDICARE: LAURA NEWMAN DAVIS SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist
2	235Z00000X	Speech-Language Pathologist	11941	NC

General Provider Information

NPI Number	:	1154899839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA NEWMAN DAVIS SLP

Provider Business Mailing Address
First Line	:	120 AFTONSHIRE CT
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27104-2702
Country	:	US
Telephone Number	:	336-793-6939
Fax Number	:

Provider Business Practice Location Address
First Line	:	3523 ELKIN HWY 268
Second Line	:
City	:	NORTH WILKESBORO
State	:	NC
Zip	:	28659-8322
Country	:	US
Telephone Number	:	336-793-6939
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2018
Last Update Date	:	11/08/2021

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Directions to “ LAURA NEWMAN DAVIS SLP” Practice Location

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