Provider Demographics
NPI:1801211099
Name:MUELLER-ANDERSON, LAURA (LICSW)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:MUELLER-ANDERSON
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 N 3RD ST STE 3
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MN
Mailing Address - Zip Code:56258-1360
Mailing Address - Country:US
Mailing Address - Phone:320-200-7552
Mailing Address - Fax:320-310-0961
Practice Address - Street 1:118 N 3RD ST STE 3
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MN
Practice Address - Zip Code:56258-1360
Practice Address - Country:US
Practice Address - Phone:320-200-7552
Practice Address - Fax:320-310-0961
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-24
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX529651041C0700X
MN258121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical