Basic Information
Provider Information
NPI: 1003408378
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMDANI
FirstName: LAURA
MiddleName: KAYE
NamePrefix:  
NameSuffix:  
Credential: M.A., CCC-SLP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 508 LOVELAND PASS CT
Address2:  
City: OSCEOLA
State: IN
PostalCode: 465618425
CountryCode: US
TelephoneNumber: 5743704326
FaxNumber:  
Practice Location
Address1: 2701 CHESTNUT STATION CT
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402996395
CountryCode: US
TelephoneNumber: 8003351060
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/08/2021
LastUpdateDate: 02/08/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 02/08/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
235Z00000X22004732AINY Speech, Language and Hearing Service ProvidersSpeech-Language Pathologist 

No ID Information.


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