Provider Demographics
NPI:1912200130
Name:LAUFENBERG, MAUREEN ELISE (MAUREEN LAUFENBERG)
Entity Type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:ELISE
Last Name:LAUFENBERG
Suffix:
Gender:F
Credentials:MAUREEN LAUFENBERG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 ADAMS ST NE APT 2
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-1466
Mailing Address - Country:US
Mailing Address - Phone:612-356-4071
Mailing Address - Fax:
Practice Address - Street 1:2809 S WAYZATA BLVD
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55405-2131
Practice Address - Country:US
Practice Address - Phone:612-377-9190
Practice Address - Fax:612-374-4498
Is Sole Proprietor?:No
Enumeration Date:2010-12-09
Last Update Date:2010-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health