Provider Demographics
NPI:1790556652
Name:LAWRENCE, LAURA V (NBCHWC)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:V
Last Name:LAWRENCE
Suffix:
Gender:F
Credentials:NBCHWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1264 RELIANCE CT
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41051-8521
Mailing Address - Country:US
Mailing Address - Phone:859-609-6813
Mailing Address - Fax:
Practice Address - Street 1:1264 RELIANCE CT
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KY
Practice Address - Zip Code:41051-8521
Practice Address - Country:US
Practice Address - Phone:859-609-6813
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-10
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYA-3197245171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach