Healthcare Provider Details

I. General information

NPI: 1932116605
Provider Name (Legal Business Name): LAURALEE ALTENDORF SPEECH LANGUAGE PATH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8729 CORAL REEF WAY
PANAMA CITY BEACH FL
32413-9601
US

IV. Provider business mailing address

8729 CORAL REEF WAY
PANAMA CITY BEACH FL
32413-9601
US

V. Phone/Fax

Practice location:
  • Phone: 224-856-8216
  • Fax: 850-725-0623
Mailing address:
  • Phone: 224-856-8216
  • Fax: 850-725-0623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSA23191
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: