Provider Demographics
NPI:1790809366
Name:BROWN, LAURA (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3350 SHELBY ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-4882
Mailing Address - Country:US
Mailing Address - Phone:909-944-2543
Mailing Address - Fax:909-944-2544
Practice Address - Street 1:3350 SHELBY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-4882
Practice Address - Country:US
Practice Address - Phone:909-944-2543
Practice Address - Fax:909-944-2544
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49040106H00000X
CA47690106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist