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Individual
LARRY W KOPPELMAN
Active
Individual
LARRY W KOPPELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
CW013360
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
334384
BC/BS PROVIDER #
PA
Enumeration date
11/03/2006
Last updated
09/24/2009
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