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General NPI Number Information
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NPI Number | 1962998534
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Entity Type | Individual
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Provider Name | LAURA CORDOVA M.ED., LPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 07/07/2018
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Last Update Date | 07/14/2018
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Provider Practice Location Address
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Address Line | 400 VESTAVIA PKWY STE 135
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City | VESTAVIA
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State | AL
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Zip | 35216
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Country | US
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Telephone | 205-913-6308
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Fax |
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Provider Business Mailing Address
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Address Line | 156 COVE LN
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City | PELHAM
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State | AL
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Zip | 35124-2869
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Country | US
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Telephone | 205-913-6308
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 3844
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License Number State | AL
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