Provider Demographics
NPI:1659668754
Name:NASH, LAURA J
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:J
Last Name:NASH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 NASSAU ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08542-4615
Mailing Address - Country:US
Mailing Address - Phone:609-921-2719
Mailing Address - Fax:609-921-2950
Practice Address - Street 1:32 SNOWDEN LN
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-3916
Practice Address - Country:US
Practice Address - Phone:609-921-2719
Practice Address - Fax:609-921-2950
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-09
Last Update Date:2011-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100158600103T00000X
NY005712-1103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist