Doctor Name: | PETER T LAUBACH |
NPI Number: | 1316953540 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW, CADC |
License Number: | 885-123 |
Business Practice Address: | 1002 Lincoln Ave Baraboo, WI - 539131808 |
Business Phone Number: | 6083569055 |
Business Fax Number: | 6083565447 |
Mailing Address: | 1002 Lincoln Ave, BARABOO |
State: | WI |
Postal Code: | 539131808 |
Phone Number: | 6083569055 |
Fax Number: | 6083565447 |
NPI Enumeration Date: | 07/31/2006 |
NPI Last Update Date: | 05/21/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 885-123 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |