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General NPI Number Information
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NPI Number | 1144562166
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Entity Type | Individual
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Provider Name | MARY ELIZABETH KUEPPER MA, L.P.C.-S
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Gender | Female
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Dates
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Enumeration Date | 03/18/2013
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 133 SMITH WAY UNIT C
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City | SOLDOTNA
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State | AK
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Zip | 99669-8077
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Country | US
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Telephone | 907-531-6047
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2653
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City | SOLDOTNA
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State | AK
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Zip | 99669-2653
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Country | US
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Telephone | 907-531-3832
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 760
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License Number State | AK
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