Provider Demographics
NPI:1225561442
Name:LACROIX, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:LACROIX
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:PO BOX 2165
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-0038
Mailing Address - Country:US
Mailing Address - Phone:404-565-3524
Mailing Address - Fax:
Practice Address - Street 1:6645 PEACHTREE DUNWOODY RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-1606
Practice Address - Country:US
Practice Address - Phone:770-455-7111
Practice Address - Fax:770-274-3460
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-05
Last Update Date:2017-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist