Provider Demographics
NPI:1740565688
Name:RICHTER, LAURA L (MS LMFT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:L
Last Name:RICHTER
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7777 GLADES RD
Mailing Address - Street 2:SUITE 207B
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33434-4194
Mailing Address - Country:US
Mailing Address - Phone:561-715-6404
Mailing Address - Fax:
Practice Address - Street 1:7777 GLADES RD
Practice Address - Street 2:SUITE 207B
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33434-4194
Practice Address - Country:US
Practice Address - Phone:561-715-6404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-11
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT2602106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist