Individual
LAURA M MACKNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D
Contact information
Practice address
9734 JUG ST. NW, PBJ CONNECTIONS, PATASKALA, OH 43062
(740) 924-7543
(740) 924-2002
Mailing address
335 NORTHRIDGE RD, COLUMBUS, OH 43214-3327
(614) 596-8574
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
5812
OH
103TC0700X
Clinical Psychologist
Primary
P.5812
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2302056
BCMH
OH
05
—
2302056
—
OH
Enumeration date
08/05/2006
Last updated
07/19/2025
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