Healthcare Provider Details

I. General information

NPI: 1093803173
Provider Name (Legal Business Name): MRS. LAURA THERESE NABOURS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. LAURA THERESE SNYDER

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1681 HICKORY LOOP
LAS CRUCES NM
88005-6587
US

IV. Provider business mailing address

301 PERKINS DR STE B
LAS CRUCES NM
88005-3248
US

V. Phone/Fax

Practice location:
  • Phone: 575-647-3773
  • Fax:
Mailing address:
  • Phone: 575-647-3773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number2035
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSAH-2025-0045
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: