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NPI Code Detail

MEDICARE: MISS LAURA ELIZABETH RAICHLE MSW, LCSWA

MEDICARE: MISS LAURA ELIZABETH RAICHLE MSW, LCSWA
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
11041C0700XClinical Social Worker

General Provider Information

NPI Number : 1538555107
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS LAURA ELIZABETH RAICHLE MSW, LCSWA
Provider Business Mailing Address
First Line : 425 WEBSTER PL
Second Line :
City : CHARLOTTE
State : NC
Zip : 28209-2334
Country : US
Telephone Number : 704-770-6551
Fax Number :
Provider Business Practice Location Address
First Line : 425 WEBSTER PL
Second Line :
City : CHARLOTTE
State : NC
Zip : 28209-2334
Country : US
Telephone Number : 704-770-6551
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2015
Last Update Date : 04/10/2015

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