Doctor Name: | LAURA ANNE PEITZ |
NPI Number: | 1013217462 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S., LPC |
License Number: | 3813 |
Business Practice Address: | 3415 Meadow Ln Ponca City, OK - 746041318 |
Business Phone Number: | 5807625948 |
Business Fax Number: | |
Mailing Address: | 3415 Meadow Ln, PONCA CITY |
State: | OK |
Postal Code: | 746041318 |
Phone Number: | 5807625948 |
Fax Number: | |
NPI Enumeration Date: | 11/01/2010 |
NPI Last Update Date: | 11/01/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 3813 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |