Provider Demographics
NPI:1285802587
Name:PATZLAFF, LAURA KAY (CSW-PIP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:KAY
Last Name:PATZLAFF
Suffix:
Gender:F
Credentials:CSW-PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5010 E ROSA PARKS PL STE 203
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-3090
Mailing Address - Country:US
Mailing Address - Phone:605-453-5708
Mailing Address - Fax:605-202-4486
Practice Address - Street 1:5010 E ROSA PARKS PL STE 203
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-3090
Practice Address - Country:US
Practice Address - Phone:605-453-5708
Practice Address - Fax:605-202-4486
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD29421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical