Provider Demographics
NPI:1104165786
Name:WEINBRECHT, LAURA ANN (MSED)
Entity type:Individual
Prefix:MISS
First Name:LAURA
Middle Name:ANN
Last Name:WEINBRECHT
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 FANNING AVE
Mailing Address - Street 2:
Mailing Address - City:HAMPTON BAYS
Mailing Address - State:NY
Mailing Address - Zip Code:11946-1811
Mailing Address - Country:US
Mailing Address - Phone:516-697-1114
Mailing Address - Fax:
Practice Address - Street 1:18 FANNING AVE
Practice Address - Street 2:
Practice Address - City:HAMPTON BAYS
Practice Address - State:NY
Practice Address - Zip Code:11946-1811
Practice Address - Country:US
Practice Address - Phone:516-697-1114
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-02
Last Update Date:2013-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251B00000XAgenciesCase Management