Individual
MICHELLE SHUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW,CSCAD
Contact information
Practice address
740 HOSPITAL WAY, HAGERSTOWN, MD 21742
(240) 313-3329
Mailing address
13114 PENNSYLVANIA AVE, HAGERSTOWN, MD 21742-2741
(240) 313-3329
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
SC1885
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
705371101
—
MD
Enumeration date
12/20/2006
Last updated
08/02/2013
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