Healthcare Provider Details

I. General information

NPI: 1437390234
Provider Name (Legal Business Name): LAURA LEE EATON PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA LEE PHILLIPS PHD

II. Dates (important events)

Enumeration Date: 03/09/2009
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2509 RESEARCH BLVD
FORT COLLINS CO
80526-8108
US

IV. Provider business mailing address

2509 RESEARCH BLVD
FORT COLLINS CO
80526-8108
US

V. Phone/Fax

Practice location:
  • Phone: 970-224-1550
  • Fax:
Mailing address:
  • Phone: 970-224-1550
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License Number1558
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number1558
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: