Provider Demographics
NPI:1730176892
Name:COHEN, LAURA A (PHD,PA)
Entity type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:A
Last Name:COHEN
Suffix:
Gender:F
Credentials:PHD,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2699 STIRLING RD
Mailing Address - Street 2:SUITE C304
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33312-6517
Mailing Address - Country:US
Mailing Address - Phone:954-893-7110
Mailing Address - Fax:954-893-1105
Practice Address - Street 1:2699 STIRLING RD
Practice Address - Street 2:SUITE C304
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33312-6517
Practice Address - Country:US
Practice Address - Phone:954-893-7110
Practice Address - Fax:954-893-1105
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2014-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0005832103TC0700X
FLPY5632103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical