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NPI Code Detail

MEDICARE: JESSICA LAUGHTON PSYD

MEDICARE:   JESSICA  LAUGHTON  PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1390200000XStudent in an Organized Health Care Education/Training Program
2103TC0700XClinical Psychologist0810007974VA

General Provider Information

NPI Number : 1093322299
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA LAUGHTON PSYD
Provider Business Mailing Address
First Line : 1657 BARKELEY AVENUE
Second Line :
City : APO
State : AA
Zip : 80913
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1848 BARKELEY AVE
Second Line : BLDG 1657
City : FORT CARSON
State : CO
Zip : 80913-0001
Country : US
Telephone Number : 719-526-3547
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2020
Last Update Date : 02/28/2024

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Directions to “ JESSICA LAUGHTON PSYD” Practice Location

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