Provider Demographics
NPI:1679839526
Name:BROWER, LAURA
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:BROWER
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 1:201 COLLEGE PL
Mailing Address - Street 2:#316
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23510-0914
Mailing Address - Country:US
Mailing Address - Phone:757-615-3003
Mailing Address - Fax:757-474-0987
Practice Address - Street 1:201 COLLEGE PL
Practice Address - Street 2:#316
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-0914
Practice Address - Country:US
Practice Address - Phone:757-615-3003
Practice Address - Fax:757-474-0987
Is Sole Proprietor?:No
Enumeration Date:2012-04-04
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1-11-8745103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst