Individual
MR. RAYMOND COPPOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CDCII, BHAII
Contact information
Practice address
333 SHORE AVE, KOTZEBUE, AK 99752-9800
(907) 442-7640
(907) 442-7749
Mailing address
PO BOX 256, KOTZEBUE, AK 99752-0256
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
1331
AK
172V00000X
Community Health Worker
—
AK
Other
Enumeration date
05/07/2007
Last updated
06/23/2020
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