Provider Demographics
NPI:1538192992
Name:PEW, LAURA N (MSW)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:N
Last Name:PEW
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5445 N CAMINO ESCUELA
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-5020
Mailing Address - Country:US
Mailing Address - Phone:520-299-2080
Mailing Address - Fax:520-299-2971
Practice Address - Street 1:4653 E PIMA ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-3437
Practice Address - Country:US
Practice Address - Phone:520-795-3369
Practice Address - Fax:520-326-9034
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZCSW1011IMedicare ID - Type Unspecified