Individual
MRS. LAURAQ ELISE SANTOMAURO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MFT
Contact information
Practice address
460 SOUTH JACKSON AVE., JACKSON, WY 83001
(307) 690-2153
Mailing address
PO BOX 1600, JACKSON, WY 83001-1600
(307) 690-2153
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
251C00000X
WY
106H00000X
Marriage & Family Therapist
Primary
PMFT 229
WY
Other
Enumeration date
11/18/2009
Last updated
11/18/2009
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