Provider Demographics
NPI:1437675386
Name:ARNOLD, LAURA BELLE
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:BELLE
Last Name:ARNOLD
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 1:952 HARMON RD APT 6
Mailing Address - Street 2:
Mailing Address - City:HARMON
Mailing Address - State:IL
Mailing Address - Zip Code:61042-9785
Mailing Address - Country:US
Mailing Address - Phone:217-440-0754
Mailing Address - Fax:
Practice Address - Street 1:325 IL ROUTE 2
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:IL
Practice Address - Zip Code:61021-9118
Practice Address - Country:US
Practice Address - Phone:815-284-6611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-22
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health