| Organization Name: | LAURA ESPINOSA PLLC |
| NPI Number: | 1053709253 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAURA MARIA ESPINOSA (LICENSED CLINICAL PSYCHOLOGIST) |
| Mailing Address: | 39520 Woodward Ave Suite 215 Bloomfield Hills |
| State: | MI US |
| Postal Code: | 483045054 |
| Phone Number: | 2489252250 |
| Fax Number: | |
| NPI Enumeration Date: | 12/23/2014 |
| NPI Last Update Date: | 03/27/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM0801X |
| License Number: | 6301015541 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
| Taxonomy Definition: | |