Provider Demographics
NPI:1043352040
Name:ZYGO, LAURA A (MED, LPC BOARD ELIGI)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:ZYGO
Suffix:
Gender:F
Credentials:MED, LPC BOARD ELIGI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 N SMITH ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28202-1474
Mailing Address - Country:US
Mailing Address - Phone:704-607-8138
Mailing Address - Fax:
Practice Address - Street 1:100 E HEARNE ST
Practice Address - Street 2:
Practice Address - City:ALBEMARLE
Practice Address - State:NC
Practice Address - Zip Code:28001-5831
Practice Address - Country:US
Practice Address - Phone:704-607-8138
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical