Provider Demographics
NPI:1013248749
Name:HUFF, LAURA M (PHD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:M
Last Name:HUFF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MISS
Other - First Name:LAURA
Other - Middle Name:M
Other - Last Name:CAPRIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1129 MACKLIND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-1440
Mailing Address - Country:US
Mailing Address - Phone:314-534-0200
Mailing Address - Fax:314-534-7996
Practice Address - Street 1:16216 BAXTER RD
Practice Address - Street 2:SUITE 399
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-4770
Practice Address - Country:US
Practice Address - Phone:636-532-9188
Practice Address - Fax:636-532-9951
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-20
Last Update Date:2010-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO01623103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO23-2812942OtherST LOUIS BEHAVIORAL MEDICINE INSTITUTE