Provider Demographics
NPI:1568515252
Name:HARWOOD, LAURA ALINE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ALINE
Last Name:HARWOOD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2810 LEXINGTON LN
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-1026
Mailing Address - Country:US
Mailing Address - Phone:847-433-3354
Mailing Address - Fax:
Practice Address - Street 1:2275 HALF DAY RD STE 145
Practice Address - Street 2:
Practice Address - City:BANNOCKBURN
Practice Address - State:IL
Practice Address - Zip Code:60015-1221
Practice Address - Country:US
Practice Address - Phone:847-433-3354
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL71006269103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical