Provider Demographics
NPI:1326816315
Name:KOPP, EMMA (MA)
Entity Type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:KOPP
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20714 NOWTHEN BLVD NW
Mailing Address - Street 2:
Mailing Address - City:NOWTHEN
Mailing Address - State:MN
Mailing Address - Zip Code:55330-8442
Mailing Address - Country:US
Mailing Address - Phone:763-412-0704
Mailing Address - Fax:
Practice Address - Street 1:620 WESLEY COMMONS DR STE 30
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55427-4079
Practice Address - Country:US
Practice Address - Phone:763-412-0704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist