MEDICARE: ROSA JOPPY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	21134	MD

General Provider Information

NPI Number	:	1558988105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSA JOPPY

Provider Business Mailing Address
First Line	:	1000 JEFFERSON ST STE 2C
Second Line	:
City	:	LYNCHBURG
State	:	VA
Zip	:	24504-1724
Country	:	US
Telephone Number	:	409-496-8082
Fax Number	:	617-807-0958

Provider Business Practice Location Address
First Line	:	19805 EXECUTIVE PARK CIR STE 29
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-2649
Country	:	US
Telephone Number	:	240-949-6808
Fax Number	:	617-807-0958

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2020
Last Update Date	:	11/18/2020

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Directions to “ ROSA JOPPY ” Practice Location

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