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NPI Code Detail

MEDICARE: DR. JOAN ALFREDA LAWRENCE PHD

MEDICARE: DR. JOAN ALFREDA LAWRENCE PHD
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
1103TC0700XClinical Psychologist4724OH
2103TC0700XClinical Psychologist6301008622MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
103283OTHERPARAMOUNT
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306844584
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOAN ALFREDA LAWRENCE PHD
Provider Business Mailing Address
First Line : PO BOX 53
Second Line :
City : BRYAN
State : OH
Zip : 43506-0053
Country : US
Telephone Number : 567-225-7954
Fax Number : 419-553-3360
Provider Business Practice Location Address
First Line : 442 W HIGH ST
Second Line :
City : BRYAN
State : OH
Zip : 43506-1681
Country : US
Telephone Number : 567-225-7954
Fax Number : 419-553-3360
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/12/2005
Last Update Date : 12/09/2025

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