Individual
MS. ANN JUDITH KOPLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(617) 667-6443
Mailing address
330 BROOKLINE AVE, BOSTON, MA 02215-5400
(617) 667-6443
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
113249
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042611055
TAX ID
MA
01
—
1004745
NHP
MA
01
—
1303287
MBHP
MA
05
—
1303287
—
MA
01
—
703136
TUFTS
MA
01
—
99618201
NETWORK HLTH
—
01
—
M18633
BCBS
MA
01
—
NP01332
BMC
MA
Enumeration date
12/13/2006
Last updated
01/04/2012
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