Individual
LAUREL ANN MAIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LP, LPC
Contact information
Practice address
10764 MCGAHAN DRIVE, FOUNTAIN, CO 80817
(719) 510-5851
Mailing address
6547 N ACADEMY BOULEVARD #1269, COLORADO SPRINGS, CO 80918
(719) 510-5851
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC.0014494
CO
103TC0700X
Clinical Psychologist
Primary
PSY.0005696
CO
Other
Enumeration date
11/24/2020
Last updated
11/15/2021
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