Provider Demographics
NPI:1235320789
Name:MCGRADY, LAURA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:MCGRADY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PALOMAR AIRPORT ROAD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92011-1028
Mailing Address - Country:US
Mailing Address - Phone:760-688-0101
Mailing Address - Fax:760-931-5617
Practice Address - Street 1:701 PALOMAR AIRPORT ROAD
Practice Address - Street 2:SUITE 300
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92011-1028
Practice Address - Country:US
Practice Address - Phone:760-688-0101
Practice Address - Fax:760-931-5617
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-08
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 21001103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling