Individual
LAURA C ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
11250 RAMONA AVE SPC 118, MONTCLAIR, CA 91763-5310
(505) 515-8129
Mailing address
11250 RAMONA AVE SPC 118, MONTCLAIR, CA 91763-5310
(505) 515-8129
(505) 158-1295
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
0189171
NM
101YP2500X
Professional Counselor
Primary
13085
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
45923779
—
NM
Enumeration date
05/22/2015
Last updated
10/28/2024
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