Provider Demographics
NPI:1235257478
Name:GRASHOW, LAURA ELLEN (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ELLEN
Last Name:GRASHOW
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:LAURA
Other - Middle Name:ELLEN
Other - Last Name:GRASHOW-RYWELL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:3151 N 47TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-2308
Mailing Address - Country:US
Mailing Address - Phone:954-962-5816
Mailing Address - Fax:
Practice Address - Street 1:19022 NE 29TH AVE
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2823
Practice Address - Country:US
Practice Address - Phone:305-936-1002
Practice Address - Fax:305-936-1022
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY6691103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent