Doctor Name: | LINDA J LAURANCE-WALSH |
NPI Number: | 1144483918 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CSAC |
License Number: | 15279 |
Business Practice Address: | 1510 Jefferson St Baraboo, WI - 539131505 |
Business Phone Number: | 6083561533 |
Business Fax Number: | |
Mailing Address: | 707 14th St, BARABOO |
State: | WI |
Postal Code: | 539131539 |
Phone Number: | 6083561400 |
Fax Number: | |
NPI Enumeration Date: | 07/02/2008 |
NPI Last Update Date: | 07/02/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 15279 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |