Provider Demographics
NPI:1326437476
Name:DANSER, LAURA (LMFT, LSATP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:DANSER
Suffix:
Gender:F
Credentials:LMFT, LSATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11535 SOUTHERN CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GIBSONTON
Mailing Address - State:FL
Mailing Address - Zip Code:33534-5355
Mailing Address - Country:US
Mailing Address - Phone:757-240-3724
Mailing Address - Fax:
Practice Address - Street 1:710 OAKFIELD DR
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-4938
Practice Address - Country:US
Practice Address - Phone:757-240-3724
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-13
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2987106H00000X
VA0717001273106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist