Provider Demographics
NPI:1174734578
Name:REID, LAURIE ANNE (LMFT)
Entity type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:ANNE
Last Name:REID
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 1:2921 S ORLANDO DR STE 164
Mailing Address - Street 2:
Mailing Address - City:SANFORD
Mailing Address - State:FL
Mailing Address - Zip Code:32773-4105
Mailing Address - Country:US
Mailing Address - Phone:954-906-1156
Mailing Address - Fax:
Practice Address - Street 1:2921 S ORLANDO DR STE 164
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:FL
Practice Address - Zip Code:32773-4105
Practice Address - Country:US
Practice Address - Phone:954-906-1156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
FLMT2295106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health