Provider Demographics
NPI:1114351103
Name:GECZY-HASKINS, LAURA A (MS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:A
Last Name:GECZY-HASKINS
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:A
Other - Last Name:GECZY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:414 N MERIDIAN ST # V298
Mailing Address - Street 2:
Mailing Address - City:NEWBERG
Mailing Address - State:OR
Mailing Address - Zip Code:97132-2697
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3710 SW US VETERANS HOSPITAL RD
Practice Address - Street 2:MENTAL HEALTH CLINIC
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2964
Practice Address - Country:US
Practice Address - Phone:503-273-5058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor