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Contact Information

ED D LAURITSEN PHD PC
218 W WHITE MOUNTAIN BLVD
SUITE D
LAKESIDE, AZ85929
 Phone: 928-367-9995
 Fax: 928-367-9988
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for ED D LAURITSEN PHD PC · (Female)

NPI Number 1720213721
Status Active
Credentials
Entity Individual
Enumeration date 05/19/2009
Last updated 05/19/2009 - About 17 years ago
Sole proprietor 1 Not specified
Identifiers
  • AZ License # 1256
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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