Individual
LAURA ATEHORTUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 CRAWFORDS CORNER RD, HOLMDEL, NJ 07733-1976
(732) 683-2322
Mailing address
10 HILLSIDE AVE APT 10, ENGLEWOOD, NJ 07631-3076
(201) 606-5756
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
TP223-047
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
TP223-047
BCBS, AETNA
NJ
Enumeration date
09/20/2022
Last updated
09/20/2022
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