Provider Demographics
NPI:1386967834
Name:ROEHRICH, LAURIE (PHD)
Entity type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:
Last Name:ROEHRICH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:INDIANA UNIVERSITY OF PENNSYLVANIA
Mailing Address - Street 2:DEPARTMENT OF PSYCHOLOGY, UHLER HALL, #203
Mailing Address - City:INDIANA
Mailing Address - State:PA
Mailing Address - Zip Code:15705-0001
Mailing Address - Country:US
Mailing Address - Phone:724-357-6228
Mailing Address - Fax:724-357-3817
Practice Address - Street 1:INDIANA UNIVERSITY OF PENNSYLVANIA
Practice Address - Street 2:CENTER FOR APPLIED PSYCHOLOGY, UHLER HALL, #210
Practice Address - City:INDIANA
Practice Address - State:PA
Practice Address - Zip Code:15705-0001
Practice Address - Country:US
Practice Address - Phone:724-357-6228
Practice Address - Fax:724-357-3817
Is Sole Proprietor?:No
Enumeration Date:2010-03-11
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS015069103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical