Provider Demographics
NPI:1265136659
Name:DUPIGNY, SORAYA
Entity type:Individual
Prefix:
First Name:SORAYA
Middle Name:
Last Name:DUPIGNY
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 1:9080 NW 24TH CT
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33322-3206
Mailing Address - Country:US
Mailing Address - Phone:954-294-7957
Mailing Address - Fax:
Practice Address - Street 1:9080 NW 24TH CT
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33322-3206
Practice Address - Country:US
Practice Address - Phone:954-294-7957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-29
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician