Individual
RAYMOND J COPPOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
103T00000X
Psychologist
Primary
022676
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1306421
—
MA
05
—
1308785
—
MA
01
—
2220002001
BCBS
MA
01
—
M18684
BCBS
MA
Enumeration date
02/27/2009
Last updated
02/27/2019
Update your record
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