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General NPI Number Information
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NPI Number | 1750094959
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Entity Type | Individual
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Provider Name | LAURA ELIZABETH GARDNER LSW
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Gender | Female
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Dates
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Enumeration Date | 01/03/2023
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 427 N SAINT MARYS ST
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City | SAINT MARYS
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State | PA
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Zip | 15857-3657
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Country | US
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Telephone | 814-834-9283
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Fax |
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Provider Business Mailing Address
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Address Line | 243 BINGHAM RD
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City | RIDGWAY
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State | PA
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Zip | 15853-5605
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Country | US
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Telephone | 814-934-2778
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | SW137558
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CW025236
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License Number State | PA
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