Provider Demographics
NPI:1124199609
Name:DR. ANN LAWRENCE, LLC
Entity Type:Organization
Organization Name:DR. ANN LAWRENCE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:CONNOR
Authorized Official - Last Name:LAWRENCE
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:414-431-3344
Mailing Address - Street 1:12900 LEE CT
Mailing Address - Street 2:
Mailing Address - City:ELM GROVE
Mailing Address - State:WI
Mailing Address - Zip Code:53122-1444
Mailing Address - Country:US
Mailing Address - Phone:414-431-3344
Mailing Address - Fax:414-434-1950
Practice Address - Street 1:12900 LEE CT
Practice Address - Street 2:
Practice Address - City:ELM GROVE
Practice Address - State:WI
Practice Address - Zip Code:53122-1444
Practice Address - Country:US
Practice Address - Phone:414-431-3344
Practice Address - Fax:414-434-1950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-13
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2103-057103T00000X
103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
No103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty