Doctor Name: | MS. LAURA CAROL CAVANAUGH |
NPI Number: | 1053498857 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPCC, LCSW |
License Number: | CC00052 |
Business Practice Address: | 1321 N Main St Viroqua, WI - 546651156 |
Business Phone Number: | 6086377052 |
Business Fax Number: | 6086378500 |
Mailing Address: | 1707 Main St, LA CROSSE |
State: | WI |
Postal Code: | 546014200 |
Phone Number: | 6087850001 |
Fax Number: | 6087850002 |
NPI Enumeration Date: | 11/01/2006 |
NPI Last Update Date: | 12/04/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | CC00052 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |