MEDICARE: LAURA SHEEDY PROMER MS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	1477	AL

General Provider Information

NPI Number	:	1134437122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA SHEEDY PROMER MS

Provider Business Mailing Address
First Line	:	300 VESTAVIA PKWY
Second Line	:	SUITE 2300
City	:	VESTAVIA
State	:	AL
Zip	:	35216-7714
Country	:	US
Telephone Number	:	205-919-0955
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 VESTAVIA PKWY
Second Line	:	SUITE 2300
City	:	VESTAVIA
State	:	AL
Zip	:	35216-7714
Country	:	US
Telephone Number	:	205-919-0955
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/23/2010
Last Update Date	:	07/18/2014

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Directions to “ LAURA SHEEDY PROMER MS” Practice Location

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