MEDICARE: SYLVIA GALVAN-KUPKE M.S.

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	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1326467879
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYLVIA GALVAN-KUPKE M.S.

Provider Business Mailing Address
First Line	:	1301 7TH ST E
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55106-4039
Country	:	US
Telephone Number	:	651-332-5500
Fax Number	:

Provider Business Practice Location Address
First Line	:	1301 7TH ST E
Second Line	:
City	:	SAINT PAUL
State	:	MN
Zip	:	55106-4039
Country	:	US
Telephone Number	:	651-332-5500
Fax Number	:

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

Provider Enumeration Date	:	04/14/2014
Last Update Date	:	04/14/2014

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