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General NPI Number Information
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NPI Number | 1326832478
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Entity Type | Individual
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Provider Name | LAURA M. LUNA PHD
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Gender | Female
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Dates
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Enumeration Date | 04/05/2025
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Last Update Date | 04/05/2025
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Provider Practice Location Address
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Address Line | 12020 SUNRISE VALLEY DR STE 100
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City | RESTON
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State | VA
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Zip | 20191-3429
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Country | US
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Telephone | 646-941-7645
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Fax | 929-596-7897
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Provider Business Mailing Address
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Address Line | 1035 HUMPHREY ST
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City | SWAMPSCOTT
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State | MA
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Zip | 01907-1416
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Country | US
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Telephone | 617-388-7977
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 0810008872
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License Number State | VA
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