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Individual

DR. PAUL LEE KOPPENHAVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
85 E NEWTON ST, BOSTON, MA 02118-2340
(800) 981-4357
(617) 414-8306
Mailing address
85 E NEWTON ST, BOSTON, MA 02118-2340
(800) 981-4357
(617) 414-8306

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
284419
MA
101YS0200X
School Counselor
284419
MA
103TS0200X
School Psychologist
Primary
284419
MA

Other

Enumeration date
04/19/2010
Last updated
04/19/2010
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