Provider Demographics
NPI:1063014629
Name:ZURELL, LAURA ALLISON (MS, 6TH YR)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:ALLISON
Last Name:ZURELL
Suffix:
Gender:F
Credentials:MS, 6TH YR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 ROUTE 87
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:CT
Mailing Address - Zip Code:06237-1410
Mailing Address - Country:US
Mailing Address - Phone:860-377-1703
Mailing Address - Fax:
Practice Address - Street 1:480 ROUTE 87
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:CT
Practice Address - Zip Code:06237-1410
Practice Address - Country:US
Practice Address - Phone:860-377-1703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1911622639103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool