Provider Demographics
NPI:1710306170
Name:FLAMISCH, LAURYN RICHELLE (MS, BSL)
Entity Type:Individual
Prefix:
First Name:LAURYN
Middle Name:RICHELLE
Last Name:FLAMISCH
Suffix:
Gender:F
Credentials:MS, BSL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5423 HEATHER LN
Mailing Address - Street 2:
Mailing Address - City:OREFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:18069-9060
Mailing Address - Country:US
Mailing Address - Phone:610-417-1697
Mailing Address - Fax:
Practice Address - Street 1:5423 HEATHER LN
Practice Address - Street 2:
Practice Address - City:OREFIELD
Practice Address - State:PA
Practice Address - Zip Code:18069-9060
Practice Address - Country:US
Practice Address - Phone:610-417-1697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-14
Last Update Date:2014-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PABH000519101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health