Provider Demographics
NPI:1346536786
Name:POTE, LAUREN (PSYD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:POTE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 NORTH ST
Mailing Address - Street 2:C/O LEE BOWBEER
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-1110
Mailing Address - Country:US
Mailing Address - Phone:203-273-0342
Mailing Address - Fax:
Practice Address - Street 1:188 NORTH ST
Practice Address - Street 2:C/O LEE BOWBEER
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06901-1110
Practice Address - Country:US
Practice Address - Phone:203-273-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002986103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical