Provider Demographics
NPI:1558767996
Name:DOSS, LAURA (BA, AAC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:DOSS
Suffix:
Gender:F
Credentials:BA, AAC
Other - Prefix:MS
Other - First Name:LAURA
Other - Middle Name:
Other - Last Name:BECK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA, AAC
Mailing Address - Street 1:3367 CHERRY LN UNIT C
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55129-7750
Mailing Address - Country:US
Mailing Address - Phone:425-350-3071
Mailing Address - Fax:
Practice Address - Street 1:1100 HANCOCK ST
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55106-5336
Practice Address - Country:US
Practice Address - Phone:425-350-3071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-12
Last Update Date:2021-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60198895101Y00000X
MN101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101Y00000XBehavioral Health & Social Service ProvidersCounselor