Provider Demographics
NPI:1790810570
Name:RHINES, LAURIE WARD (MA MARRIAGE AND FA)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:WARD
Last Name:RHINES
Suffix:
Gender:F
Credentials:MA MARRIAGE AND FA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 COPPER BEECH LN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:CT
Mailing Address - Zip Code:06480-1579
Mailing Address - Country:US
Mailing Address - Phone:860-342-5089
Mailing Address - Fax:860-342-5089
Practice Address - Street 1:41C NEW LONDON TPKE
Practice Address - Street 2:
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-4206
Practice Address - Country:US
Practice Address - Phone:860-342-5089
Practice Address - Fax:860-342-5089
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000690106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist