Healthcare Provider Details

I. General information

NPI: 1114477056
Provider Name (Legal Business Name): MRS. LAURA SIGMON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2016
Last Update Date: 11/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7234 PRICE PT
DENVER NC
28037-8019
US

IV. Provider business mailing address

7234 PRICE PT
DENVER NC
28037-8019
US

V. Phone/Fax

Practice location:
  • Phone: 828-773-4806
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code222Q00000X
TaxonomyDevelopmental Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: