Provider Demographics
NPI:1366789521
Name:BOECKMAN, LAURAL CATHERINE (LPC)
Entity type:Individual
Prefix:MS
First Name:LAURAL
Middle Name:CATHERINE
Last Name:BOECKMAN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7707 S IH 35
Mailing Address - Street 2:APT. 533
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78744-5500
Mailing Address - Country:US
Mailing Address - Phone:806-790-5016
Mailing Address - Fax:
Practice Address - Street 1:7707 S IH 35
Practice Address - Street 2:APT. 533
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78744-5500
Practice Address - Country:US
Practice Address - Phone:806-790-5016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX66975101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional