MEDICARE: LAURIE WEBB

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	SA16848	FL
2	235Z00000X	Speech-Language Pathologist	144.0128767	VT
3	235Z00000X	Speech-Language Pathologist	3906	MA

General Provider Information

NPI Number	:	1457907628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURIE WEBB

Provider Business Mailing Address
First Line	:	2448 VT ROUTE 22A
Second Line	:
City	:	BRIDPORT
State	:	VT
Zip	:	05734-9778
Country	:	US
Telephone Number	:	978-317-5184
Fax Number	:

Provider Business Practice Location Address
First Line	:	2448 VT ROUTE 22A
Second Line	:
City	:	BRIDPORT
State	:	VT
Zip	:	05734-9778
Country	:	US
Telephone Number	:	978-317-5184
Fax Number	:

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

Provider Enumeration Date	:	08/14/2019
Last Update Date	:	08/14/2019

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Directions to “ LAURIE WEBB ” Practice Location

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