Provider Demographics
NPI:1518728146
Name:WANKEL, LAURA CATHRINE
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:CATHRINE
Last Name:WANKEL
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 1:170 MEETING ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-3153
Mailing Address - Country:US
Mailing Address - Phone:843-983-8320
Mailing Address - Fax:772-675-9100
Practice Address - Street 1:170 MEETING ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29401-3153
Practice Address - Country:US
Practice Address - Phone:843-983-8320
Practice Address - Fax:772-675-9100
Is Sole Proprietor?:No
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106E00000XBehavioral Health & Social Service ProvidersAssistant Behavior Analyst