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General NPI Number Information
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NPI Number | 1821372533
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Entity Type | Individual
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Provider Name | LAURIE ELIZABETH MCCALL SLP
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Gender | Female
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Dates
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Enumeration Date | 09/30/2011
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Last Update Date | 09/30/2011
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Provider Practice Location Address
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Address Line | 3025 SW RESERVOIR DR
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City | REDMOND
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State | OR
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Zip | 97756-9481
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Country | US
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Telephone | 541-548-5066
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Fax |
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Provider Business Mailing Address
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Address Line | 1106 NW STANNIUM RD
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City | BEND
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State | OR
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Zip | 97701-2141
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Country | US
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Telephone | 541-408-4944
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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 | 12434
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 6470
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License Number State | CA
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