Provider Demographics
NPI:1922151141
Name:SODEN, LAURA MARGARET (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MARGARET
Last Name:SODEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 356
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:12932-0356
Mailing Address - Country:US
Mailing Address - Phone:518-873-2434
Mailing Address - Fax:518-873-2432
Practice Address - Street 1:208 WATER STREET
Practice Address - Street 2:SUITE 21
Practice Address - City:ELIZABETHTOWN
Practice Address - State:NY
Practice Address - Zip Code:12932-0356
Practice Address - Country:US
Practice Address - Phone:518-873-2434
Practice Address - Fax:518-873-2432
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012954-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical