Peterson, Laurie
Peterson, Laurie is an sole proprietor health care provider with primary practice located at 121B Lee St , Carrollton GA 30117-3314. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Peterson, Laurie can be contacted via phone (770) 830-8622.Contact Information
Primary practice address
121B Lee St
Carrollton GA 30117-3314
Phone: (770) 830-8622
Fax: (770) 832-9031
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | SLP009608 | Georgia |
Profile Details
| NPI number | 1811412810 |
|---|---|
| LBN Legal business name | Peterson, Laurie |
| Credentials | Master of Education (MED) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 10th, 2017 |
| Last updated | Mar 22nd, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811412810 | NPPES |
| Georgia | MEDICAID | 003193324A | |
| Georgia | Other | 05026948 |
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