Provider Demographics
NPI:1184275174
Name:LUPTON, LAUREN
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:LUPTON
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 1:190 MOUNTAIN AVE
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07933-1605
Mailing Address - Country:US
Mailing Address - Phone:908-591-4236
Mailing Address - Fax:
Practice Address - Street 1:190 MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:NJ
Practice Address - Zip Code:07933-1605
Practice Address - Country:US
Practice Address - Phone:908-591-4236
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-22
Last Update Date:2019-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst