Provider Demographics
NPI:1144772427
Name:DERING, LAURA LYNN (MS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:LYNN
Last Name:DERING
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 1:5353 GAMBLE DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-1509
Mailing Address - Country:US
Mailing Address - Phone:612-747-3945
Mailing Address - Fax:
Practice Address - Street 1:5353 GAMBLE DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-1509
Practice Address - Country:US
Practice Address - Phone:612-747-3945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-02
Last Update Date:2016-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health