Provider Demographics
NPI:1457676850
Name:TIEULI, LAUREN BETH (MA)
Entity Type:Individual
Prefix:MISS
First Name:LAUREN
Middle Name:BETH
Last Name:TIEULI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 WALDEN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-3614
Mailing Address - Country:US
Mailing Address - Phone:978-369-7611
Mailing Address - Fax:
Practice Address - Street 1:148 WALDEN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-3614
Practice Address - Country:US
Practice Address - Phone:978-369-7611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-03-29
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health