Individual
STACY MARIE KOPP
Active
Individual
STACY MARIE KOPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
1104947-30
WI
Other
Enumeration date
08/07/2023
Last updated
08/07/2023
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