Laura Marie Waller, MA.,SLT,M-ED

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

#SLP1151 Issued in AZ

Practice address

Arrowhead Elementary School 7490 W. Union Hills Dr.
Glendale, AZ 85308

Phone

(623) 376-4100

NPI assigned

Apr 9, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education, Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912020587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6902 W WESCOTT DR",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853085783",
            "telephone_number": "623-412-2040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ARROWHEAD ELEMENTARY SCHOOL 7490 W. UNION HILLS DR.",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "85308",
            "telephone_number": "623-376-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "LAURA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "MA.,SLT,M-ED",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "AZ",
            "license": "#SLP1151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terence Tarell Walker, STUDENT
• Alyssa Walla, RBT
• Dustin Wade Wallace, LCSW
• Edward Wallace, M.D.
• Mike Thomas Wallace, L.P.C.
• Elizabeth Robyn Wallmann, D.D.S.
• Walmart Inc.
• Walmart Inc.
• Walmart Inc.
• Walmart Inc.

• Speech-Language Pathologist in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Speech-Language Pathologist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.