Healthcare Provider Details

I. General information

NPI: 1003728023
Provider Name (Legal Business Name): LAURA REAPER CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MEDICAL CENTER EAST, SOUTH TOWER 1215 21ST AVE. SOUTH, SUITE 7302
NASHVILLE TN
37232
US

IV. Provider business mailing address

2118 ACKLEN AVE APT 6
NASHVILLE TN
37212-3531
US

V. Phone/Fax

Practice location:
  • Phone: 615-343-7464
  • Fax:
Mailing address:
  • Phone: 615-322-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14469829
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: