Provider Demographics
NPI:1083721393
Name:PREISS, LAURA M (CSAC)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:M
Last Name:PREISS
Suffix:
Gender:F
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11390 W THEODORE TRECKER WAY
Mailing Address - Street 2:
Mailing Address - City:WEST ALLIS
Mailing Address - State:WI
Mailing Address - Zip Code:53214-1135
Mailing Address - Country:US
Mailing Address - Phone:414-928-1401
Mailing Address - Fax:414-928-1402
Practice Address - Street 1:11390 W THEODORE TRECKER WAY
Practice Address - Street 2:
Practice Address - City:WEST ALLIS
Practice Address - State:WI
Practice Address - Zip Code:53214-1135
Practice Address - Country:US
Practice Address - Phone:414-928-1401
Practice Address - Fax:414-928-1402
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1530101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)