Individual
LAURA ELIZABETH WALLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8440 PIT STOP CT NW, CONCORD, NC 28027-8245
(704) 960-1729
Mailing address
2675 COURT DR, GASTONIA, NC 28054-1478
(704) 824-7800
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
9391
NC
Other
Enumeration date
09/04/2018
Last updated
09/19/2018
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