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General NPI Number Information
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NPI Number | 1467503821
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Entity Type | Individual
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Provider Name | LAURA ANN GERAGHTY LCSW
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Gender | Female
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Dates
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Enumeration Date | 01/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 9449 N 90TH ST SUITE 210
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5099
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Country | US
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Telephone | 480-451-8500
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Fax |
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Provider Business Mailing Address
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Address Line | 5547 E GARNET AVE
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City | MESA
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State | AZ
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Zip | 85206-6726
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Country | US
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Telephone | 480-218-4465
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCSW-12184
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License Number State | AZ
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