Healthcare Provider Details

I. General information

NPI: 1013248749
Provider Name (Legal Business Name): LAURA M HUFF PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MISS LAURA M CAPRIO

II. Dates (important events)

Enumeration Date: 01/20/2010
Last Update Date: 01/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16216 BAXTER RD SUITE 399
CHESTERFIELD MO
63017-4770
US

IV. Provider business mailing address

1129 MACKLIND AVE
SAINT LOUIS MO
63110-1440
US

V. Phone/Fax

Practice location:
  • Phone: 636-532-9188
  • Fax: 636-532-9951
Mailing address:
  • Phone: 314-534-0200
  • Fax: 314-534-7996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number01623
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: