Provider Demographics
NPI:1568294015
Name:ALDRIDGE DEREMER, LAURA MADELINE
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MADELINE
Last Name:ALDRIDGE DEREMER
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 1:9201 E MISSISSIPPI AVE APT G206
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80247-6820
Mailing Address - Country:US
Mailing Address - Phone:720-633-1338
Mailing Address - Fax:
Practice Address - Street 1:9200 W CROSS DR STE 509
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-0761
Practice Address - Country:US
Practice Address - Phone:303-551-9214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor