Provider Demographics
NPI:1346911286
Name:LAWRENCE, GERMAINE N (MFT)
Entity Type:Individual
Prefix:
First Name:GERMAINE
Middle Name:N
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 COWPERTHWAITE ST APT 63E
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811-5504
Mailing Address - Country:US
Mailing Address - Phone:203-815-2706
Mailing Address - Fax:
Practice Address - Street 1:489 COWPERTHWAITE ST APT 63E
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-5504
Practice Address - Country:US
Practice Address - Phone:203-815-2706
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-21
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist