Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TC1900X | Counseling Psychologist | 6139302-2501 | UT |
Y | 103TC1900X | Counseling Psychologist | 9168 | MA |
NPI | 1053637785 |
---|---|
Provider Name | Ms. Lisa Marie Kulpinski |
First Address | North Andover, MA 01845-3709 |
Second Address | North Andover, MA 01845-1664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/04/2010 |
Last Update Date | 20/04/2010 |