Healthcare Provider Details

I. General information

NPI: 1952303661
Provider Name (Legal Business Name): LAURA LEIGH POST MD, PHD, JD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 12/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

143 TUN JOAQUIN SANTOS LANE
TUMON GU
96913-3223
US

IV. Provider business mailing address

1270 N. MARINE CORPS DRIVE #101 PMB 889
TAMUNING GU
96913-3223
US

V. Phone/Fax

Practice location:
  • Phone: 671-647-1961
  • Fax: 671-979-1046
Mailing address:
  • Phone: 671-647-1961
  • Fax: 671-979-1046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberG64320
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberM1382
License Number StateGU
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number217
License Number StateMP
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number14876
License Number StateNV
# 5
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number17087
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: