Provider Demographics
NPI:1134222375
Name:DESSAUER, LAURA J (MS, ATR-BC, LCAT)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:J
Last Name:DESSAUER
Suffix:
Gender:F
Credentials:MS, ATR-BC, LCAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2735 FLOYD ST
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2623
Mailing Address - Country:US
Mailing Address - Phone:941-504-8498
Mailing Address - Fax:
Practice Address - Street 1:2735 FLOYD ST
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2623
Practice Address - Country:US
Practice Address - Phone:941-504-8498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000202-1221700000X
NY000634-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health