Doctor Name: | LAURA HARTWAY |
NPI Number: | 1003954025 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A., LPC |
License Number: | L912751 |
Business Practice Address: | 21885 Dunham Rd Ste. 1 Clinton Township, MI - 480361030 |
Business Phone Number: | 5864695955 |
Business Fax Number: | |
Mailing Address: | 21885 Dunham Rd, Ste. 1 CLINTON TOWNSHIP |
State: | MI |
Postal Code: | 480361030 |
Phone Number: | 5864695955 |
Fax Number: | |
NPI Enumeration Date: | 02/02/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | L912751 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |