Provider Demographics
NPI:1942767058
Name:TOBIAS, LAURYN JANE (EDS, PLPC)
Entity Type:Individual
Prefix:
First Name:LAURYN
Middle Name:JANE
Last Name:TOBIAS
Suffix:
Gender:F
Credentials:EDS, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7053 N MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:MO
Mailing Address - Zip Code:65251-6395
Mailing Address - Country:US
Mailing Address - Phone:254-290-1959
Mailing Address - Fax:
Practice Address - Street 1:401 N KEENE ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6625
Practice Address - Country:US
Practice Address - Phone:573-874-8818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-25
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health