Provider Demographics
NPI:1114290947
Name:DAVI, LAURA M (MS, NCC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:DAVI
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 LYRICAL LN
Mailing Address - Street 2:
Mailing Address - City:SANDY HOOK
Mailing Address - State:CT
Mailing Address - Zip Code:06482-1614
Mailing Address - Country:US
Mailing Address - Phone:203-364-1464
Mailing Address - Fax:
Practice Address - Street 1:30 LYRICAL LN
Practice Address - Street 2:
Practice Address - City:SANDY HOOK
Practice Address - State:CT
Practice Address - Zip Code:06482-1614
Practice Address - Country:US
Practice Address - Phone:203-364-1464
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-09
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health