Healthcare Provider Details

I. General information

NPI: 1326488222
Provider Name (Legal Business Name): LAUREN WOODRUFF RASMUSSEN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 06/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6555 PERKINS RD
BATON ROUGE LA
70808-4237
US

IV. Provider business mailing address

6555 PERKINS RD
BATON ROUGE LA
70808-4237
US

V. Phone/Fax

Practice location:
  • Phone: 225-368-2297
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number1220
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: