Provider Demographics
NPI:1912259672
Name:FLOREK, LAURA-ANNE COLLETTI (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LAURA-ANNE
Middle Name:COLLETTI
Last Name:FLOREK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:286 MORNING GLORY DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NJ
Mailing Address - Zip Code:08831-5340
Mailing Address - Country:US
Mailing Address - Phone:908-415-3402
Mailing Address - Fax:
Practice Address - Street 1:286 MORNING GLORY DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NJ
Practice Address - Zip Code:08831-5340
Practice Address - Country:US
Practice Address - Phone:908-415-3402
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-04
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ4957103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical