Provider Demographics
NPI:1396891156
Name:HEINRICH, LAURA GRIFFIN (MFT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:GRIFFIN
Last Name:HEINRICH
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 N. MOUNTAIN STREET
Mailing Address - Street 2:ROSS BUILDING 3-H
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 MOUNTAIN ST
Practice Address - Street 2:ROSS BUILDING 3-H
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3822
Practice Address - Country:US
Practice Address - Phone:775-445-7756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01021106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist