Provider Demographics
NPI:1699596700
Name:ST.CLAIR, LAURA (MA ED)
Entity type:Individual
Prefix:MS
First Name:LAURA
Middle Name:
Last Name:ST.CLAIR
Suffix:
Gender:F
Credentials:MA ED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7096 FAIRWAY RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:VA
Mailing Address - Zip Code:24153-6522
Mailing Address - Country:US
Mailing Address - Phone:540-597-9217
Mailing Address - Fax:
Practice Address - Street 1:2727 ELECTRIC RD STE 103
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-3500
Practice Address - Country:US
Practice Address - Phone:540-354-0911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health