Provider Demographics
NPI:1003929324
Name:WRENN, LAURA J (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:J
Last Name:WRENN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 JACK BREAULT DR
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:WI
Mailing Address - Zip Code:54016-4547
Mailing Address - Country:US
Mailing Address - Phone:715-629-8300
Mailing Address - Fax:
Practice Address - Street 1:2201 JACK BREAULT DR
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:WI
Practice Address - Zip Code:54016-4547
Practice Address - Country:US
Practice Address - Phone:715-629-8300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2018-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI8141-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical