Provider Demographics
NPI:1417266420
Name:MUNRO, LAURA JESSICA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:JESSICA
Last Name:MUNRO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14515 LEFFINGWELL RD
Mailing Address - Street 2:APARTMENT 71
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90604-2852
Mailing Address - Country:US
Mailing Address - Phone:562-713-3294
Mailing Address - Fax:
Practice Address - Street 1:14515 LEFFINGWELL RD
Practice Address - Street 2:APARTMENT 71
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90604-2852
Practice Address - Country:US
Practice Address - Phone:562-713-3294
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-26
Last Update Date:2010-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health