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General NPI Number Information
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NPI Number | 1720233786
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Entity Type | Individual
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Provider Name | LAURA CAMILLE HARDY MS CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/18/2008
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Last Update Date | 11/18/2008
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Provider Practice Location Address
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Address Line | 407 14TH AVE SE
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City | PUYALLUP
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State | WA
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Zip | 98372-3770
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Country | US
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Telephone | 253-697-2711
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Fax | 253-697-5180
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Provider Business Mailing Address
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Address Line | 4533B NE 55TH ST
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City | SEATTLE
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State | WA
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Zip | 98105-2937
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Country | US
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Telephone | 706-825-8578
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | LL 00004464
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License Number State | WA
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