Provider Demographics
NPI:1366707259
Name:LAUKAITIS, ELAINE G (SLP A)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:G
Last Name:LAUKAITIS
Suffix:
Gender:F
Credentials:SLP A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15560 N FRANK LLOYD WRIGHT BLVD
Mailing Address - Street 2:B4-408
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2091
Mailing Address - Country:US
Mailing Address - Phone:480-383-9111
Mailing Address - Fax:
Practice Address - Street 1:15560 N FRANK LLOYD WRIGHT BLVD
Practice Address - Street 2:B4-408
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-2091
Practice Address - Country:US
Practice Address - Phone:480-383-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-07
Last Update Date:2012-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA 7684235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist