Provider Demographics
NPI:1114295367
Name:INNIGER, LAURA ANN (LMFT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN
Last Name:INNIGER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 HENDRICKS ST
Mailing Address - Street 2:
Mailing Address - City:BERNE
Mailing Address - State:IN
Mailing Address - Zip Code:46711-2326
Mailing Address - Country:US
Mailing Address - Phone:260-849-3605
Mailing Address - Fax:
Practice Address - Street 1:915 S 11TH ST
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:IN
Practice Address - Zip Code:46733-3406
Practice Address - Country:US
Practice Address - Phone:260-301-3155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN35002038A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist