Provider Demographics
NPI:1154526416
Name:HESS, LAURA GREISS (MS OTRL)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:GREISS
Last Name:HESS
Suffix:
Gender:F
Credentials:MS OTRL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2825 50TH ST
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2308
Mailing Address - Country:US
Mailing Address - Phone:916-703-0393
Mailing Address - Fax:916-703-0344
Practice Address - Street 1:2825 50TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2308
Practice Address - Country:US
Practice Address - Phone:916-703-0393
Practice Address - Fax:916-703-0344
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 1607174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist