=====================================================
General NPI Number Information
=====================================================
NPI Number | 1144506247
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAURA VARO MS CCC-SLP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/02/2011
-----------------------------------------------------
Last Update Date | 02/14/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 300 W MAY ST
-----------------------------------------------------
City | MARENGO
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52301-1261
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-642-8040
-----------------------------------------------------
Fax | 319-642-8003
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 300 W MAY ST
-----------------------------------------------------
City | MARENGO
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 52301-1261
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 319-642-8040
-----------------------------------------------------
Fax | 319-642-8003
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 082925
-----------------------------------------------------
License Number State | IA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 2841-154
-----------------------------------------------------
License Number State | WI
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 235Z00000X
-----------------------------------------------------
Taxonomy Name | Speech-Language Pathologist
-----------------------------------------------------
License Number | 146009173
-----------------------------------------------------
License Number State | IL
-----------------------------------------------------