MEDICARE: LAURALEES SPEECH THERAPY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	224Z00000X	Occupational Therapy Assistant
2	225100000X	Physical Therapist
3	225200000X	Physical Therapy Assistant
4	251E00000X	Home Health Agency
5	225X00000X	Occupational Therapist
6	2355S0801X	Speech-Language Assistant
7	235Z00000X	Speech-Language Pathologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1942323951	OTHER	AZ	AHCCCS

General Provider Information

NPI Number	:	1992427314
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAURALEES SPEECH THERAPY

Provider Business Mailing Address
First Line	:	1110 E PRESS RD
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85140-5425
Country	:	US
Telephone Number	:	480-245-8577
Fax Number	:

Provider Business Practice Location Address
First Line	:	1110 E PRESS RD
Second Line	:
City	:	SAN TAN VALLEY
State	:	AZ
Zip	:	85140-5425
Country	:	US
Telephone Number	:	480-245-8577
Fax Number	:

Authorized Official
Title or Position	:	OWNER/AUTHORIZED SIGNATORY
Name	:	LAURALEE J LARKIN
Credential	:
Telephone Number	:	480-245-8577

Provider Enumeration Date	:	09/13/2022
Last Update Date	:	08/27/2024

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Directions to “LAURALEES SPEECH THERAPY ” Practice Location

Language	Start Address	Practice Location

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