Provider Demographics
NPI:1952523573
Name:PRIMAKOFF, LAURA (PHD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:PRIMAKOFF
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11200 WHISPERWOOD LANE
Mailing Address - Street 2:
Mailing Address - City:ROCKIVLLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-3670
Mailing Address - Country:US
Mailing Address - Phone:301-299-6888
Mailing Address - Fax:
Practice Address - Street 1:7825 TUCKERMAN LANE
Practice Address - Street 2:SUITE 209
Practice Address - City:POTOMAC
Practice Address - State:MD
Practice Address - Zip Code:20854
Practice Address - Country:US
Practice Address - Phone:301-299-6888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01829103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral