Provider Demographics
NPI:1346954567
Name:LAWRENCE, COLEEN MARGURITE (MSSL, EJD)
Entity Type:Individual
Prefix:
First Name:COLEEN
Middle Name:MARGURITE
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:MSSL, EJD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1616 US HIGHWAY 395 N
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NV
Mailing Address - Zip Code:89423-4109
Mailing Address - Country:US
Mailing Address - Phone:775-790-7022
Mailing Address - Fax:
Practice Address - Street 1:1616 US HIGHWAY 395 N
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-4109
Practice Address - Country:US
Practice Address - Phone:775-790-7022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-11
Last Update Date:2023-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor