Doctor Name: | MS. LAURA MICHELLE GARDNER |
NPI Number: | 1215952346 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.S. |
License Number: | |
Business Practice Address: | 8 N Grove St Lock Haven, PA - 177453547 |
Business Phone Number: | 8147482262 |
Business Fax Number: | 5707485870 |
Mailing Address: | 158 S Harrison Rd, PLEASANT GAP |
State: | PA |
Postal Code: | 168233320 |
Phone Number: | 8143592764 |
Fax Number: | |
NPI Enumeration Date: | 07/12/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |