Provider Demographics
NPI:1962893883
Name:FALDUTO, LAURA LEE (PHD)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:LEE
Last Name:FALDUTO
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8736 E SAN PABLO DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-2629
Mailing Address - Country:US
Mailing Address - Phone:602-679-0602
Mailing Address - Fax:
Practice Address - Street 1:8736 E SAN PABLO DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-2629
Practice Address - Country:US
Practice Address - Phone:602-679-6027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-13
Last Update Date:2015-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3186103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist