Individual
ELISHA STUPPY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSW
Contact information
Practice address
292 GLADES RD STE 8, BEREA, KY 40403-1368
(859) 428-7862
(859) 972-0616
Mailing address
PO BOX 802, BEREA, KY 40403-0802
(859) 986-5452
(859) 972-0616
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/04/2019
Last updated
01/04/2019
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