Provider Demographics
NPI:1306150297
Name:ESPINOSA-GIALDI, LAURA MARIA (PSYS, TLLP)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIA
Last Name:ESPINOSA-GIALDI
Suffix:
Gender:F
Credentials:PSYS, TLLP
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:LAURA
Other - Last Name:ESPINOSA-GIALDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYS, TLLP
Mailing Address - Street 1:43755 SAINT JULIAN CT
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-1804
Mailing Address - Country:US
Mailing Address - Phone:586-254-8686
Mailing Address - Fax:
Practice Address - Street 1:11111 HALL RD
Practice Address - Street 2:SUITE 303
Practice Address - City:UTICA
Practice Address - State:MI
Practice Address - Zip Code:48317-5711
Practice Address - Country:US
Practice Address - Phone:248-925-2250
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301014451103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist