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General NPI Number Information
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NPI Number | 1932200102
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Entity Type | Individual
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Provider Name | LAURA C DEGRANDIS PSYD
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 34970 DETROIT RD UNIT 210A
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City | AVON
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State | OH
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Zip | 44011-2654
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Country | US
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Telephone | 480-385-8223
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Fax |
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Provider Business Mailing Address
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Address Line | 36459 S PARK DR
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City | AVON
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State | OH
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Zip | 44011-3506
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Country | US
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Telephone | 480-385-8223
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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 | 7325
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License Number State | OH
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