Healthcare Provider Details

I. General information

NPI: 1841320488
Provider Name (Legal Business Name): ANN F LASER LPC LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2007
Last Update Date: 01/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

270 CALLE LOMA NORTE
SANTA FE NM
87501
US

IV. Provider business mailing address

PO BOX 1243
JONESBORO AR
72401
US

V. Phone/Fax

Practice location:
  • Phone: 505-490-0286
  • Fax:
Mailing address:
  • Phone: 505-490-0286
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberP9001004
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number0072651
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberM9710013
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: