Provider Demographics
NPI:1780930925
Name:LAWRENCE, EMILY JANE (PHD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:JANE
Last Name:LAWRENCE
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 1:220 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:MURPHYS
Mailing Address - State:CA
Mailing Address - Zip Code:95247-9337
Mailing Address - Country:US
Mailing Address - Phone:209-728-9010
Mailing Address - Fax:
Practice Address - Street 1:5283 OLD BROWNSVILLE RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78405-3908
Practice Address - Country:US
Practice Address - Phone:361-806-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-25
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL103T00000X103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical