Vicki Lynn Soponski

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Dudley, MA

NPI 1104259134 · NPPES record last updated Aug 13, 2013

Key facts

NPI
1104259134
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
13 Michael LN
Dudley, MA 01571-5885
Phone
(774) 230-6116
NPI assigned
Aug 13, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

13 Michael LN
Dudley, MA 01571-5885

Mailing address

13 Michael LN
Dudley, MA 01571-5885
Phone (774) 230-6116

Other providers in Dudley, MA

All providers in Dudley, MA · Student in an Organized Health Care Education/Training Program in Massachusetts

Sources for this page

Verify at the official NPI Registry.