Provider Demographics
NPI:1518946375
Name:HENNINGER, LAURA MARIE (PT)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:MARIE
Last Name:HENNINGER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:MARIE
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:625 LINCOLN AVE.
Mailing Address - Street 2:SUITE 209
Mailing Address - City:N. CHARLEROI
Mailing Address - State:PA
Mailing Address - Zip Code:15022-2451
Mailing Address - Country:US
Mailing Address - Phone:724-483-2159
Mailing Address - Fax:724-489-0282
Practice Address - Street 1:625 LINCOLN AVE.
Practice Address - Street 2:SUITE 107
Practice Address - City:N. CHARLEROI
Practice Address - State:PA
Practice Address - Zip Code:15022-2451
Practice Address - Country:US
Practice Address - Phone:724-483-4886
Practice Address - Fax:724-483-0519
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT 006114L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00070127OtherRAILROAD MEDICARE
PA536355OtherHIGHMARK BLUE SHIELD
055639 P3DMedicare ID - Type Unspecified