| Ed D Lauritsen Phd Pc | |
|
218 W White Mountain Blvd Suite D Lakeside AZ 85929 | |
| (928) 367-9995 | |
| (928) 367-9988 |
| Full Name | Ed D Lauritsen Phd Pc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 218 W White Mountain Blvd, Lakeside, Arizona |
| Authorized Official Name and Position | Ed D Lauritsen (PRESIDENT) |
| Authorized Official Contact | 9283679995 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ed D Lauritsen Phd Pc 218 W White Mountain Blvd Suite D Lakeside AZ 85929 Ph: (928) 367-9995 | Ed D Lauritsen Phd Pc 218 W White Mountain Blvd Suite D Lakeside AZ 85929 Ph: (928) 367-9995 |
| NPI Number | 1720213721 |
|---|---|
| Provider Enumeration Date | 05/19/2009 |
| Last Update Date | 05/19/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720213721 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 1256 (Arizona) | Primary |
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