Provider Demographics
NPI:1467028670
Name:LAIDLER, CATHERINE LYNN
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:LYNN
Last Name:LAIDLER
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 1:2500 MAITLAND CENTER PKWY STE 250
Mailing Address - Street 2:
Mailing Address - City:MAITLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32751-4174
Mailing Address - Country:US
Mailing Address - Phone:407-351-7080
Mailing Address - Fax:
Practice Address - Street 1:2500 MAITLAND CENTER PKWY STE 250
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4174
Practice Address - Country:US
Practice Address - Phone:407-351-7080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-28
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH17491101YA0400X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)