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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