Individual
BRYSSA KOPPIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25 VIA LUCCA APT J345, IRVINE, CA 92612-0674
(651) 592-8949
Mailing address
25 VIA LUCCA APT J345, IRVINE, CA 92612-0674
(651) 592-8949
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
118448
CA
106S00000X
Behavior Technician
—
—
Other
Enumeration date
09/12/2022
Last updated
10/08/2023
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