Healthcare Provider Details

I. General information

NPI: 1811187255
Provider Name (Legal Business Name): LAURA ANNE RAUSCHER M.ED., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 08/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 OFALLON PLZ
O FALLON MO
63366-2640
US

IV. Provider business mailing address

120 OFALLON PLZ
O FALLON MO
63366-2640
US

V. Phone/Fax

Practice location:
  • Phone: 314-749-9432
  • Fax:
Mailing address:
  • Phone: 314-749-9432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2005009025
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: