Provider Demographics
NPI:1093090540
Name:CUPRILL, LAUREEN MARGARET
Entity Type:Individual
Prefix:MISS
First Name:LAUREEN
Middle Name:MARGARET
Last Name:CUPRILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 FOURTH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11220
Mailing Address - Country:US
Mailing Address - Phone:718-360-8193
Mailing Address - Fax:718-439-3965
Practice Address - Street 1:5220 FOURTH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11220-1812
Practice Address - Country:US
Practice Address - Phone:718-360-8193
Practice Address - Fax:718-360-8193
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-17
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor