Provider Demographics
NPI:1396912291
Name:MORAN-MARSH, LAURIE (NP-P)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:
Last Name:MORAN-MARSH
Suffix:
Gender:F
Credentials:NP-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MARSHALL RD STE 2L
Mailing Address - Street 2:
Mailing Address - City:WAPPINGERS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12590-4134
Mailing Address - Country:US
Mailing Address - Phone:845-298-4350
Mailing Address - Fax:845-298-4354
Practice Address - Street 1:11 MARSHALL RD STE 2L
Practice Address - Street 2:
Practice Address - City:WAPPINGERS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12590-4134
Practice Address - Country:US
Practice Address - Phone:845-298-4350
Practice Address - Fax:845-298-4354
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY345572-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health