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General NPI Number Information
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NPI Number | 1699187906
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Entity Type | Individual
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Provider Name | LAURA THORESON PSY.D
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Gender | Female
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Dates
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Enumeration Date | 05/21/2014
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 3000 POLAR LN STE 101
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City | CEDAR PARK
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State | TX
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Zip | 78613-3065
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Country | US
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Telephone | 844-824-8775
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2631
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City | GUASTI
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State | CA
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Zip | 91743-2631
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Country | US
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Telephone |
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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 | 26374
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 40055
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License Number State | TX
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