Provider Demographics
NPI:1659781060
Name:ROMSDAHL, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:ROMSDAHL
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 1:401 N LOOP 336 W
Mailing Address - Street 2:SUITE C
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77301-1200
Mailing Address - Country:US
Mailing Address - Phone:713-878-8500
Mailing Address - Fax:936-242-6254
Practice Address - Street 1:401 N LOOP 336 W
Practice Address - Street 2:SUITE C
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-1200
Practice Address - Country:US
Practice Address - Phone:713-878-8500
Practice Address - Fax:936-242-6254
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical