MEDICARE: LAURA MARGARET DEER 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	16418	CA

General Provider Information

NPI Number	:	1801155981
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA MARGARET DEER M.S. CCC/SLP

Provider Business Mailing Address
First Line	:	5341 LOMA LINDA AVE #19
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-4087
Country	:	US
Telephone Number	:	310-529-6760
Fax Number	:

Provider Business Practice Location Address
First Line	:	5341 LOMA LINDA AVE APT 19
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-4087
Country	:	US
Telephone Number	:	310-529-6760
Fax Number	:

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

Provider Enumeration Date	:	05/10/2012
Last Update Date	:	07/21/2022

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