Provider Demographics
NPI:1497417398
Name:CADA, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:CADA
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 1:465 HICKORY LN N
Mailing Address - Street 2:
Mailing Address - City:OAKDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55128-7036
Mailing Address - Country:US
Mailing Address - Phone:651-955-9033
Mailing Address - Fax:
Practice Address - Street 1:2103 COUNTY ROAD D E
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:MN
Practice Address - Zip Code:55109-5357
Practice Address - Country:US
Practice Address - Phone:651-748-5019
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-07
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3018101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional