Provider Demographics
NPI:1225302094
Name:MOWRY-HESLER, LAURIE LEIGH (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:LEIGH
Last Name:MOWRY-HESLER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:LEIGH
Other - Last Name:HESLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:22636 GLENN DR
Mailing Address - Street 2:SUITE105
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-4494
Mailing Address - Country:US
Mailing Address - Phone:703-464-0877
Mailing Address - Fax:
Practice Address - Street 1:2 PIDGEON HILL DR
Practice Address - Street 2:SUITE 450
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20165-6145
Practice Address - Country:US
Practice Address - Phone:703-901-9721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-26
Last Update Date:2012-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC26055106H00000X
VA0717001237106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist