Provider Demographics
NPI:1235470949
Name:TODD, LAURIE ANN
Entity Type:Individual
Prefix:
First Name:LAURIE
Middle Name:ANN
Last Name:TODD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAURIE
Other - Middle Name:ANN
Other - Last Name:JOHANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8751 COLLIN MCKINNEY PKWY STE 205
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-1658
Mailing Address - Country:US
Mailing Address - Phone:940-220-9307
Mailing Address - Fax:833-263-6680
Practice Address - Street 1:8751 COLLIN MCKINNEY PKWY STE 205
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-1658
Practice Address - Country:US
Practice Address - Phone:940-220-9307
Practice Address - Fax:833-263-6680
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-05
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX76330101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional