Organization
KAITLYN LAURIE, S.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAITLYN LAURIE LPC (OWNER)
(605) 235-3546
Entity
Organization
Contact information
Practice address
6320 MONONA DR, MONONA, WI 53716-3952
(608) 235-3546
Mailing address
6320 MONONA DR, MONONA, WI 53716-3952
(608) 235-3546
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1915125
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42221000
—
WI
Enumeration date
04/17/2011
Last updated
04/17/2011
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