| Doctor Name: | MS. LAURA SHEREE BRUNT MACLEOD |
| NPI Number: | 1114092525 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | PY00003806 |
| Business Practice Address: | 15418 Main St Mill Creek, WA - 980129030 |
| Business Phone Number: | 4253395453 |
| Business Fax Number: | 4252258028 |
| Mailing Address: | Po Box 5127, EVERETT |
| State: | WA |
| Postal Code: | 982065127 |
| Phone Number: | 4252583900 |
| Fax Number: | |
| NPI Enumeration Date: | 11/21/2006 |
| NPI Last Update Date: | 09/06/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | PY00003806 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |