Individual
LAURA MARIE BEVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
905 SHADY OAKS CT, MISHAWAKA, IN 46544-6753
(574) 440-5420
Mailing address
905 SHADY OAKS CT, MISHAWAKA, IN 46544-6753
(574) 440-5420
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004508A
IN
Other
Enumeration date
08/19/2019
Last updated
08/19/2019
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