Provider Demographics
NPI:1073328639
Name:WOODWARD, LAURA EMILY
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:EMILY
Last Name:WOODWARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 PRESCOTT DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66049-3662
Mailing Address - Country:US
Mailing Address - Phone:785-218-3762
Mailing Address - Fax:
Practice Address - Street 1:1811 WAKARUSA DR STE 102
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-2082
Practice Address - Country:US
Practice Address - Phone:785-371-4921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMLP03401-T101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health