Doctor Name: | LAURA ANN JAUREQUI |
NPI Number: | 1043493836 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | SCHOOL PSYCHOLOGIST |
License Number: | 262714 |
Business Practice Address: | 12 Twin Buttes Drive Zuni, NM - 87327 |
Business Phone Number: | 5758387242 |
Business Fax Number: | |
Mailing Address: | 12 Twin Buttes Drive, ZUNI |
State: | NM |
Postal Code: | 87327 |
Phone Number: | 5758387242 |
Fax Number: | |
NPI Enumeration Date: | 12/14/2007 |
NPI Last Update Date: | 10/17/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TS0200X |
License Number: | 262714 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | School |
Taxonomy Definition: |