# MS. MARY ALICE POUPON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1073949509
- **Gender:** F
- **Credential:** NPP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 002708 | CT | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 7903263 | NY | — |
| 364SP0807X | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist | 002708 | CT | — |
| 364SP0807X | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist | 7903263 | NY | — |

## Other

- **Enumeration date:** 09/16/2013
- **Last updated:** 04/30/2025