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Organization

MARANATHA LAURA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LAURA LAVERNE COOK M.ED. (LPC)
(573) 358-4393
Entity
Organization

Contact information

Practice address
7233 HILLSBORO RD, BONNE TERRE, MO 63628-3491
(573) 358-4393
Mailing address
7233 HILLSBORO RD, BONNE TERRE, MO 63628-3491
(573) 358-4393

Taxonomy

Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
2000154534
MO

Other

Enumeration date
09/26/2011
Last updated
09/26/2011
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