MEDICARE: CHRISTINE E TUPPER MED

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1598950305
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE E TUPPER MED

Provider Business Mailing Address
First Line	:	28A FOREST ST
Second Line	:
City	:	ROCKPORT
State	:	MA
Zip	:	01966-1307
Country	:	US
Telephone Number	:	508-284-5556
Fax Number	:

Provider Business Practice Location Address
First Line	:	28A FOREST ST
Second Line	:
City	:	ROCKPORT
State	:	MA
Zip	:	01966-1307
Country	:	US
Telephone Number	:	508-284-5556
Fax Number	:

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

Provider Enumeration Date	:	09/14/2007
Last Update Date	:	09/14/2007

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