Provider Demographics
NPI:1164816625
Name:BEGIN, LAURA REGINA (COTA)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:REGINA
Last Name:BEGIN
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 CRYSTAL DR
Mailing Address - Street 2:APT 825
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-4121
Mailing Address - Country:US
Mailing Address - Phone:917-969-8729
Mailing Address - Fax:
Practice Address - Street 1:1501 CRYSTAL DR
Practice Address - Street 2:APT 825
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-4121
Practice Address - Country:US
Practice Address - Phone:917-969-8729
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-23
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0131000075171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor