Provider Demographics
NPI:1508992330
Name:SECREST, LAURA ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ANN
Last Name:SECREST
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ROCKMEAD DR
Mailing Address - Street 2:SUITE 175
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-2112
Mailing Address - Country:US
Mailing Address - Phone:281-780-4776
Mailing Address - Fax:281-582-6457
Practice Address - Street 1:800 ROCKMEAD DR
Practice Address - Street 2:SUITE 175
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-2112
Practice Address - Country:US
Practice Address - Phone:281-780-4776
Practice Address - Fax:281-582-6457
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-26
Last Update Date:2010-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33797103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical