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NPI Code Detail

MEDICARE: MARY P COPPINGER MS LMFT

MEDICARE:   MARY P COPPINGER  MS LMFT
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
1106H00000XMarriage & Family Therapist0587KY

General Provider Information

NPI Number : 1750368254
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY P COPPINGER MS LMFT
Provider Business Mailing Address
First Line : 1169 EASTERN PKWY
Second Line : SUITE 1155
City : LOUISVILLE
State : KY
Zip : 40217-1417
Country : US
Telephone Number : 502-297-2448
Fax Number : 877-570-9832
Provider Business Practice Location Address
First Line : 1169 EASTERN PKWY
Second Line : SUITE 1155
City : LOUISVILLE
State : KY
Zip : 40217-1417
Country : US
Telephone Number : 502-297-2448
Fax Number : 877-570-9832
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/27/2005
Last Update Date : 02/12/2008

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