Individual
EDDIE DUANE LAURITSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
1141 E COOLEY ST, STE E, SHOW LOW, AZ 85901-5103
(928) 537-0370
(928) 537-1189
Mailing address
1141 E COOLEY ST, STE E, SHOW LOW, AZ 85901-5103
(928) 537-0370
(928) 537-1189
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1256
AZ
Other
Enumeration date
09/20/2005
Last updated
07/08/2007
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