Healthcare Provider Details

I. General information

NPI: 1013417260
Provider Name (Legal Business Name): LAURIE STRUEBY MS CCC SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/14/2018
Last Update Date: 10/31/2022
Certification Date: 10/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9240 COUNTY VIEW RD
DALLAS TX
75249-1124
US

IV. Provider business mailing address

1222 BROOKVALLEY DR
ARLINGTON TX
76018-2960
US

V. Phone/Fax

Practice location:
  • Phone: 972-708-2060
  • Fax:
Mailing address:
  • Phone: 817-487-2515
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number15173
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: