Organization
KATHLEEN LAUREN EDD PLLC
Active
Other names
Kathleen Lauren
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA L FREITAG (BILLING AGENT)
(970) 686-0970
Entity
Organization
Contact information
Practice address
4674 SNOW MESA DR, STE 100, FORT COLLINS, CO 80528
(970) 221-1073
(970) 221-9380
Mailing address
PO BOX 492, WINDSOR, CO 80550
(970) 686-0970
(970) 686-0341
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
1990
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
69323780
—
CO
Enumeration date
07/14/2006
Last updated
08/22/2020
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