Provider Demographics
NPI:1073409942
Name:GAYMAN, LAURA LEE
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:LEE
Last Name:GAYMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:LEE
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:BEHAVIORAL HEALTH SPECIALIST
Mailing Address - Street 2:910 EASY STREET
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415
Mailing Address - Country:US
Mailing Address - Phone:530-510-6455
Mailing Address - Fax:707-465-4272
Practice Address - Street 1:DHHS COUNTY OF DEL NORTE (BHD)
Practice Address - Street 2:455 K ST
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531
Practice Address - Country:US
Practice Address - Phone:707-464-7224
Practice Address - Fax:707-465-4272
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1073409942372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion