Individual
LAURA MAURILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1955 DALLAS HWY NW, STE 1200, SALEM, OR 97304-4466
(503) 362-4101
Mailing address
377 NW JASPER ST, DALLAS, OR 97338-1279
(503) 623-1844
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
015071
OR
Other
Enumeration date
02/19/2014
Last updated
02/19/2014
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