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1760520068
CHARLES J. COPPOLO
PORT JERVIS, NY
NPI
1760520068
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NY 060301)
Enumeration Date
2007-02-01
Last Update Date
2007-07-08
Business Address
Mr. CHARLES J. COPPOLO LCSW
137 HAMMOND ST
PORT JERVIS, NY 12771-2608
Phone number: 845-858-8911
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Mailing Address
Mr. CHARLES J. COPPOLO LCSW
137 HAMMOND ST
PORT JERVIS, NY 12771-2608
Phone number: 845-858-8911
Copy
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