Doctor Name: | CARLA LAURY |
NPI Number: | 1104194703 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 302 Belvue Terrace Aston, PA - 19014 |
Business Phone Number: | 6103480090 |
Business Fax Number: | |
Mailing Address: | 302 Belvue Terrace, ASTON |
State: | PA |
Postal Code: | 19014 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 12/09/2011 |
NPI Last Update Date: | 12/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |