Healthcare Provider Details

I. General information

NPI: 1417672478
Provider Name (Legal Business Name): LAURA ELIZABETH KLEPPE MS, CGC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LAURA ELIZABETH MUELLER MS, CGC

II. Dates (important events)

Enumeration Date: 10/11/2022
Last Update Date: 10/11/2022
Certification Date: 10/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 LUDLOW ST FL TOWER8
STAMFORD CT
06902-6987
US

IV. Provider business mailing address

5 CINDY LN
HOLMDEL NJ
07733-2026
US

V. Phone/Fax

Practice location:
  • Phone: 800-298-6470
  • Fax:
Mailing address:
  • Phone: 201-655-8596
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License Number25MJ00031200
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: