Provider Demographics
NPI:1184878407
Name:LENKEY, LAURA E (PH D)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:E
Last Name:LENKEY
Suffix:
Gender:F
Credentials:PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2206 MITCHELL PARK DR
Mailing Address - Street 2:UNIT 14
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-8674
Mailing Address - Country:US
Mailing Address - Phone:231-348-7777
Mailing Address - Fax:231-348-7777
Practice Address - Street 1:2206 MITCHELL PARK DR
Practice Address - Street 2:UNIT 14
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-8674
Practice Address - Country:US
Practice Address - Phone:231-348-7777
Practice Address - Fax:231-348-7777
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2008-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1780687095OtherORGANIZATION NPI NUMBER
MIOP61310OtherPTAN