Provider Demographics
NPI:1861719767
Name:VAN VELDHOVEN, LAURA MARIE (PHD, MPH)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:MARIE
Last Name:VAN VELDHOVEN
Suffix:
Gender:F
Credentials:PHD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 WESLAYAN ST
Mailing Address - Street 2:SUITE 485
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5132
Mailing Address - Country:US
Mailing Address - Phone:713-632-1145
Mailing Address - Fax:
Practice Address - Street 1:2900 WESLAYAN ST
Practice Address - Street 2:SUITE 485
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5132
Practice Address - Country:US
Practice Address - Phone:713-632-1145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-01
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33949103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist