Organization
LAURA WAGSTAFF LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA WAGSTAFF LICENSED CLINICIAN (OWNER)
(205) 913-3780
Entity
Organization
Contact information
Practice address
4 OFFICE PARK CIR STE 208, MOUNTAIN BRK, AL 35223-2671
(205) 913-3780
Mailing address
4 OFFICE PARK CIR STE 208, MOUNTAIN BRK, AL 35223-2671
(205) 913-3780
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Enumeration date
02/28/2024
Last updated
02/28/2024
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