Provider Demographics
NPI:1346743614
Name:LAURIA, SABRINA
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:
Last Name:LAURIA
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 1:4660 3RD AVE SW
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-2928
Mailing Address - Country:US
Mailing Address - Phone:239-330-5907
Mailing Address - Fax:
Practice Address - Street 1:4660 3RD AVE SW
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-2928
Practice Address - Country:US
Practice Address - Phone:239-330-5907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-13
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL802047938OtherCFARS
FL805041995OtherFARS