Provider Demographics
NPI:1386839652
Name:PRATCHETT, LAURA CLAIRE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:CLAIRE
Last Name:PRATCHETT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3217 CAMBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-3645
Mailing Address - Country:US
Mailing Address - Phone:858-997-7202
Mailing Address - Fax:
Practice Address - Street 1:130 W KINGSBRIDGE RD
Practice Address - Street 2:526 OOMH
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10468
Practice Address - Country:US
Practice Address - Phone:718-741-4000
Practice Address - Fax:718-741-4775
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-11
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018723103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical