Provider Demographics
NPI:1427388677
Name:FERGUSON, LAURA LEE (MED, BCABA)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:LEE
Last Name:FERGUSON
Suffix:
Gender:F
Credentials:MED, BCABA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 EAST MARKET ST.
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206
Mailing Address - Country:US
Mailing Address - Phone:502-596-1252
Mailing Address - Fax:502-596-1420
Practice Address - Street 1:1100 E. MARKET ST.
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206
Practice Address - Country:US
Practice Address - Phone:502-596-1252
Practice Address - Fax:502-596-1420
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst