Healthcare Provider Details

I. General information

NPI: 1447576954
Provider Name (Legal Business Name): MEGHAN CUPOLI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2010
Last Update Date: 04/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2-20 AUTUMN LEAF DRIVE
NASHUA NH
03060
US

IV. Provider business mailing address

2 AUTUMN LEAF DR APT 20
NASHUA NH
03060-5548
US

V. Phone/Fax

Practice location:
  • Phone: 508-439-9489
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: