| Doctor Name: | LAURA SUE HENSON |
| NPI Number: | 1164506952 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSYD LP |
| License Number: | LP2072 |
| Business Practice Address: | 6401 University Ave Ne Bhsi Llc Suite 304 Fridley, MN - 554324344 |
| Business Phone Number: | 6517696250 |
| Business Fax Number: | 6517696299 |
| Mailing Address: | 2497 7th Ave E, Co Bhsi Llc NORTH ST PAUL |
| State: | MN |
| Postal Code: | 551092496 |
| Phone Number: | 6517696437 |
| Fax Number: | 6517696426 |
| NPI Enumeration Date: | 10/25/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | LP2072 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |