Individual
JESSICA COPPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 PINE STREET, HAMBURG, NY 14075
(716) 646-4991
(716) 646-4990
Mailing address
3176 ABBOTT RD UNIT A, ORCHARD PARK, NY 14127-1069
(716) 646-4991
(716) 646-4990
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
07/25/2017
Last updated
08/03/2017
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