Provider Demographics
NPI:1992990691
Name:LAURA LEE HUSER, PH.D., L.L.C.
Entity type:Organization
Organization Name:LAURA LEE HUSER, PH.D., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HUSER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:602-604-9440
Mailing Address - Street 1:1702 E HIGHLAND AVE
Mailing Address - Street 2:SUITE 318
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4664
Mailing Address - Country:US
Mailing Address - Phone:602-604-9440
Mailing Address - Fax:602-604-9600
Practice Address - Street 1:1702 E HIGHLAND AVE
Practice Address - Street 2:SUITE 318
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4664
Practice Address - Country:US
Practice Address - Phone:602-604-9440
Practice Address - Fax:602-604-9600
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3649103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty