Provider Demographics
NPI:1427368604
Name:MCAULIFFE, LAURA M (MFT)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:M
Last Name:MCAULIFFE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9492 DOUBLE R BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-4820
Mailing Address - Country:US
Mailing Address - Phone:775-722-8316
Mailing Address - Fax:775-322-8316
Practice Address - Street 1:9492 DOUBLE R BLVD STE B
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-4820
Practice Address - Country:US
Practice Address - Phone:775-722-8316
Practice Address - Fax:775-322-8316
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-20
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV01248106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist