Provider Demographics
NPI:1609239797
Name:COSIO, LAURA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:COSIO
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2277 HIGHWAY 36 W
Mailing Address - Street 2:#310
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-3804
Mailing Address - Country:US
Mailing Address - Phone:612-331-4429
Mailing Address - Fax:621-331-3520
Practice Address - Street 1:2277 HIGHWAY 36 W
Practice Address - Street 2:SUITE 310
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-3804
Practice Address - Country:US
Practice Address - Phone:612-331-4429
Practice Address - Fax:612-331-3520
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3206106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist