Healthcare Provider Details

I. General information

NPI: 1467479360
Provider Name (Legal Business Name): LAURA MARIE CONNOR ED D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

278 LAFAYETTE RD BLDG E WEST ENTRY
PORTSMOUTH NH
03801
US

IV. Provider business mailing address

278 LAFAYETTE RD BLDG E WEST ENTRY
PORTSMOUTH NH
03801
US

V. Phone/Fax

Practice location:
  • Phone: 603-436-6887
  • Fax: 603-436-5530
Mailing address:
  • Phone: 603-436-6887
  • Fax: 603-436-5530

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number302
License Number StateNH
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number0810003525
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: