Provider Demographics
NPI:1588854517
Name:LASH, LAURIE ANN (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:ANN
Last Name:LASH
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 1:625 PANORAMA TRL STE 2170
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14625-2433
Mailing Address - Country:US
Mailing Address - Phone:585-218-0515
Mailing Address - Fax:585-218-0516
Practice Address - Street 1:625 PANORAMA TRL STE 2170
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14625-2433
Practice Address - Country:US
Practice Address - Phone:585-218-0515
Practice Address - Fax:585-218-0516
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-26
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017060103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist