Provider Demographics
NPI:1225168396
Name:SASSEEN, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:SASSEEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:951 E BOGARD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99654-7113
Mailing Address - Country:US
Mailing Address - Phone:907-357-8622
Mailing Address - Fax:907-357-8624
Practice Address - Street 1:951 E BOGARD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7113
Practice Address - Country:US
Practice Address - Phone:907-357-8622
Practice Address - Fax:907-357-8624
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-06
Last Update Date:2008-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator