Provider Demographics
NPI:1063639946
Name:ASPLUND, LAURIE ANN (MS)
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANN
Last Name:ASPLUND
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W8022 SMOCK VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-9256
Mailing Address - Country:US
Mailing Address - Phone:608-966-3465
Mailing Address - Fax:608-966-3140
Practice Address - Street 1:310 N MIDVALE BLVD STE 202
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53705-3265
Practice Address - Country:US
Practice Address - Phone:608-238-9991
Practice Address - Fax:608-238-1929
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2840-125101YM0800X, 101YP2500X
WI605-124106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39797400Medicaid