| NPI | 1447957477 |
|---|---|
| Former Name | LAUREL BURST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AK 217904) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AK 205222) |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2026-03-17 |