Provider Demographics
NPI:1023196482
Name:VINCENT-ARNOLD, LAURA L (MS ATR-BC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:L
Last Name:VINCENT-ARNOLD
Suffix:
Gender:F
Credentials:MS ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2461 N 63RD ST
Mailing Address - Street 2:
Mailing Address - City:WAUWATOSA
Mailing Address - State:WI
Mailing Address - Zip Code:53213-1545
Mailing Address - Country:US
Mailing Address - Phone:414-431-8162
Mailing Address - Fax:
Practice Address - Street 1:2461 N 63RD ST
Practice Address - Street 2:
Practice Address - City:WAUWATOSA
Practice Address - State:WI
Practice Address - Zip Code:53213-1545
Practice Address - Country:US
Practice Address - Phone:414-431-8162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist