Provider Demographics
NPI:1437466984
Name:MURPHY, LAURA DIANE (MA, LLP)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:DIANE
Last Name:MURPHY
Suffix:
Gender:F
Credentials:MA, LLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21736 FARMINGTON RD
Mailing Address - Street 2:APT. 213
Mailing Address - City:FARMINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48336-4440
Mailing Address - Country:US
Mailing Address - Phone:313-333-3650
Mailing Address - Fax:
Practice Address - Street 1:8750 TELEGRAPH RD
Practice Address - Street 2:SUITE 108
Practice Address - City:TAYLOR
Practice Address - State:MI
Practice Address - Zip Code:48180-2397
Practice Address - Country:US
Practice Address - Phone:313-299-8600
Practice Address - Fax:313-299-8600
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2010-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012866103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical