Individual
DR. JENNIFER LAUREN COPPOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D., LMFT
Contact information
Practice address
4500 PEWTER LN # 89, MANLIUS, NY 13104-9707
(315) 414-9743
Mailing address
4641 PAULI DR, MANLIUS, NY 13104-2419
(585) 732-8852
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
001637
NY
Other
Enumeration date
02/08/2020
Last updated
02/08/2020
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