Provider Demographics
NPI:1003356726
Name:CHIESA, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:CHIESA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9455 SKY VISTA PKWY APT 23A
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89506-2052
Mailing Address - Country:US
Mailing Address - Phone:202-725-0539
Mailing Address - Fax:
Practice Address - Street 1:9455 SKY VISTA PKWY APT 23A
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89506-2052
Practice Address - Country:US
Practice Address - Phone:202-725-0539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2017-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health