Provider Demographics
NPI:1457474595
Name:ELIAS, LAURA J (ASSS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:J
Last Name:ELIAS
Suffix:
Gender:F
Credentials:ASSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:URB. JARDINAS DE BORINQUEN
Mailing Address - Street 2:E #7
Mailing Address - City:AGUADILLA
Mailing Address - State:PR
Mailing Address - Zip Code:00603
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:ANRXO HOSPITAL BUEN SAMARITANO
Practice Address - Street 2:CENTRO DE TRATAMIENTO CON METADONA DE AGUADILLA
Practice Address - City:AGUADILLA
Practice Address - State:PR
Practice Address - Zip Code:00603
Practice Address - Country:US
Practice Address - Phone:787-891-2360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)