MEDICARE: MRS. LAURA SHNIDERMAN M.S. , CCC-SLP

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	SLP0647	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	589228	OTHER	AZ	AHCCS

General Provider Information

NPI Number	:	1578745899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LAURA SHNIDERMAN M.S. , CCC-SLP

Provider Business Mailing Address
First Line	:	4156 E MCDONALD DR
Second Line	:
City	:	PARADISE VALLEY
State	:	AZ
Zip	:	85253-3934
Country	:	US
Telephone Number	:	602-317-5337
Fax Number	:

Provider Business Practice Location Address
First Line	:	4156 E MCDONALD DR
Second Line	:
City	:	PARADISE VALLEY
State	:	AZ
Zip	:	85253-3934
Country	:	US
Telephone Number	:	602-317-5337
Fax Number	:

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

Provider Enumeration Date	:	11/28/2007
Last Update Date	:	11/28/2007

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Directions to “ MRS. LAURA SHNIDERMAN M.S. , CCC-SLP” Practice Location

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