Provider Demographics
NPI:1366789554
Name:COPPRUE-LANHAM, TANYA (MSW, HS-BCP, CSS)
Entity type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:
Last Name:COPPRUE-LANHAM
Suffix:
Gender:F
Credentials:MSW, HS-BCP, CSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 ROUTE 22 STE 2000
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-2943
Mailing Address - Country:US
Mailing Address - Phone:732-231-2312
Mailing Address - Fax:
Practice Address - Street 1:1200 ROUTE 22 STE 2000
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-2943
Practice Address - Country:US
Practice Address - Phone:732-231-2312
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2014-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor