Provider Demographics
NPI:1366582843
Name:MOHR, LAURA ANN (PHD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:ANN
Last Name:MOHR
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 1:2815 S PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE #2
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48910-3496
Mailing Address - Country:US
Mailing Address - Phone:517-377-8648
Mailing Address - Fax:517-377-8595
Practice Address - Street 1:2815 S PENNSYLVANIA AVE
Practice Address - Street 2:SUITE #2
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48910-3496
Practice Address - Country:US
Practice Address - Phone:517-377-8648
Practice Address - Fax:517-377-8595
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4101006215106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist