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General NPI Number Information
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NPI Number | 1962526558
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Entity Type | Individual
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Provider Name | LAURA ANN MARTIN M.S., CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 12/10/2015
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Provider Practice Location Address
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Address Line | 3201 CHERRY RIDGE ST STE C323
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City | SAN ANTONIO
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State | TX
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Zip | 78230-4823
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Country | US
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Telephone | 210-349-1415
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Fax | 210-349-1417
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Provider Business Mailing Address
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Address Line | 3201 CHERRY RIDGE ST STE C323
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City | SAN ANTONIO
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State | TX
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Zip | 78230-4823
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Country | US
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Telephone | 210-349-1415
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Fax | 210-349-1417
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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 | 19599
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License Number State | TX
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