Provider Demographics
NPI:1902379720
Name:DODDS, LAURE L (MS, LMHCA)
Entity Type:Individual
Prefix:
First Name:LAURE
Middle Name:L
Last Name:DODDS
Suffix:
Gender:F
Credentials:MS, LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 2ND ST STE 101
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-2997
Mailing Address - Country:US
Mailing Address - Phone:425-200-4890
Mailing Address - Fax:
Practice Address - Street 1:605 2ND ST STE 101
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2997
Practice Address - Country:US
Practice Address - Phone:425-200-4890
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60885056101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty