Provider Demographics
NPI:1518984459
Name:HUSER, LAURA LEE (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:LEE
Last Name:HUSER
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 1:1702 E HIGHLAND AVE
Mailing Address - Street 2:SUITE 318
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4664
Mailing Address - Country:US
Mailing Address - Phone:602-604-9440
Mailing Address - Fax:602-604-9600
Practice Address - Street 1:1702 E HIGHLAND AVE
Practice Address - Street 2:SUITE 318
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4664
Practice Address - Country:US
Practice Address - Phone:602-604-9440
Practice Address - Fax:602-604-9600
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3649103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ108800Medicare UPIN