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General NPI Number Information
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NPI Number | 1467928655
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Entity Type | Individual
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Provider Name | ASHLEY JEAN KOPP
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Gender | Female
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Dates
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Enumeration Date | 10/16/2018
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 214 ELM ST STE 207
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City | WASHINGTON
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State | MO
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Zip | 63090-2340
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Country | US
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Telephone | 573-680-1390
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 35
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City | HERMANN
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State | MO
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Zip | 65041-0035
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Country | US
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Telephone | 573-680-1390
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | MO2018029242
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License Number State | MO
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