Provider Demographics
NPI:1437641149
Name:ENGLISH, LAURIE E
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:E
Last Name:ENGLISH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19115 GLENDALE CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49456-2335
Mailing Address - Country:US
Mailing Address - Phone:616-607-4997
Mailing Address - Fax:
Practice Address - Street 1:9001 MILLER RD STE 5
Practice Address - Street 2:
Practice Address - City:SWARTZ CREEK
Practice Address - State:MI
Practice Address - Zip Code:48473-1115
Practice Address - Country:US
Practice Address - Phone:616-607-4997
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-30
Last Update Date:2018-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician