Provider Demographics
NPI:1376055244
Name:ESQUER, LAURA ALEJANDRA (LASAC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:ALEJANDRA
Last Name:ESQUER
Suffix:
Gender:F
Credentials:LASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4343 N 21ST ST APT 214
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-0504
Mailing Address - Country:US
Mailing Address - Phone:928-257-5830
Mailing Address - Fax:
Practice Address - Street 1:3550 E PINCHOT AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-7434
Practice Address - Country:US
Practice Address - Phone:602-957-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-31
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLASAC-15145101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor