Provider Demographics
NPI:1326534926
Name:HANLON, LAURA (L)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:HANLON
Suffix:
Gender:F
Credentials:L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PINETREE DR
Mailing Address - Street 2:
Mailing Address - City:KATONAH
Mailing Address - State:NY
Mailing Address - Zip Code:10536-3334
Mailing Address - Country:US
Mailing Address - Phone:914-588-3870
Mailing Address - Fax:
Practice Address - Street 1:3 PINETREE DR
Practice Address - Street 2:
Practice Address - City:KATONAH
Practice Address - State:NY
Practice Address - Zip Code:10536-3334
Practice Address - Country:US
Practice Address - Phone:914-588-3870
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-06
Last Update Date:2018-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0540021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical