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General NPI Number Information
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NPI Number | 1811142417
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Entity Type | Individual
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Provider Name | LAURA MARIE ANDERSON PHD
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Gender | Female
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Dates
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Enumeration Date | 11/24/2008
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Last Update Date | 08/29/2024
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Provider Practice Location Address
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Address Line | 1055 MAPLE ROAD, BACK
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City | WILLIAMSVILLE
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State | NY
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Zip | 14221
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Country | US
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Telephone | 716-222-1950
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Fax | 716-237-4531
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Provider Business Mailing Address
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Address Line | PO BOX 1042
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City | WILLIAMSVILLE
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State | NY
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Zip | 14231-1042
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Country | US
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Telephone | 716-222-1950
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 019540
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License Number State | NY
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