Provider Demographics
NPI:1770790222
Name:VEITH, LAURA JANE (LMFT)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:JANE
Last Name:VEITH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 607
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73402-0607
Mailing Address - Country:US
Mailing Address - Phone:580-226-2717
Mailing Address - Fax:580-226-2819
Practice Address - Street 1:120 A ST NW
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-6209
Practice Address - Country:US
Practice Address - Phone:580-226-2717
Practice Address - Fax:580-226-2819
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK297106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist