Provider Demographics
NPI:1366124463
Name:ANDRICH, LAURA
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:ANDRICH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 E ILLINOIS ST
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-2628
Mailing Address - Country:US
Mailing Address - Phone:360-466-8268
Mailing Address - Fax:
Practice Address - Street 1:611 E ILLINOIS ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-2628
Practice Address - Country:US
Practice Address - Phone:360-466-8268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW614527571041C0700X
COCSW099292941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical