Provider Demographics
NPI:1932200102
Name:DEGRANDIS, LAURA C (PSYD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:C
Last Name:DEGRANDIS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36459 S PARK DR
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-3506
Mailing Address - Country:US
Mailing Address - Phone:480-385-8223
Mailing Address - Fax:
Practice Address - Street 1:34970 DETROIT RD UNIT 210A
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-2654
Practice Address - Country:US
Practice Address - Phone:480-385-8223
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7325103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical