Individual
MRS. LAURA MADLYN HARRISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCADC
Contact information
Practice address
234 MAPLE AVE, RED BANK, NJ 07701-1731
(732) 747-1035
(732) 747-1069
Mailing address
234 MAPLE AVE, PO BOX 812, RED BANK, NJ 07701-1731
(732) 747-1035
(732) 747-1069
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
37LC00126700
NJ
Other
Enumeration date
06/11/2007
Last updated
07/08/2007
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