Provider Demographics
NPI:1346390804
Name:TAYLOR, LAURA HANSON (MSW LCSW)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:HANSON
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MSW LCSW
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Mailing Address - Street 1:1115 IRONWOOD DR STE C
Mailing Address - Street 2:FAMILY SUPPORT SERVICES OF NORTH IDAHO
Mailing Address - City:COUER D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814
Mailing Address - Country:US
Mailing Address - Phone:208-769-4222
Mailing Address - Fax:208-667-7557
Practice Address - Street 1:1115 IRONWOOD DR STE C
Practice Address - Street 2:FAMILY SUPPORT SERVICES OF NORTH IDAHO
Practice Address - City:COUER D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814
Practice Address - Country:US
Practice Address - Phone:208-769-4222
Practice Address - Fax:208-667-7557
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ID273121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical