Provider Demographics
NPI:1710628268
Name:ORMEROID, LAURA FULLER (MSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:FULLER
Last Name:ORMEROID
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1923 N TREKELL RD
Mailing Address - Street 2:
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85122-1706
Mailing Address - Country:US
Mailing Address - Phone:520-635-5460
Mailing Address - Fax:520-423-3461
Practice Address - Street 1:1923 N TREKELL RD
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85122-1706
Practice Address - Country:US
Practice Address - Phone:520-635-5460
Practice Address - Fax:520-423-3461
Is Sole Proprietor?:No
Enumeration Date:2022-04-06
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW21638104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker