Provider Demographics
NPI:1598550204
Name:MARTIN, LAURA NICOLE (MA)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:NICOLE
Last Name:MARTIN
Suffix:
Gender:
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 PATHWAY DR
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-7762
Mailing Address - Country:US
Mailing Address - Phone:914-629-3427
Mailing Address - Fax:
Practice Address - Street 1:2401 PATHWAY DR
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27516-7762
Practice Address - Country:US
Practice Address - Phone:914-629-3427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-12
Last Update Date:2025-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist