Doctor Name: | LAURA RAZAVI |
NPI Number: | 1073884425 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | SLP003749 |
Business Practice Address: | 65 Darcee Ct Lawrenceville, GA - 300467402 |
Business Phone Number: | 6788584777 |
Business Fax Number: | |
Mailing Address: | 5065 Wild Ginger Cv, NORCROSS |
State: | GA |
Postal Code: | 300925144 |
Phone Number: | 7705821067 |
Fax Number: | |
NPI Enumeration Date: | 01/17/2012 |
NPI Last Update Date: | 01/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SLP003749 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |