Provider Demographics
NPI:1588013544
Name:COPELIN, MICHON
Entity Type:Individual
Prefix:MS
First Name:MICHON
Middle Name:
Last Name:COPELIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5117 BACCICH ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70122-6212
Mailing Address - Country:US
Mailing Address - Phone:504-415-9680
Mailing Address - Fax:504-218-5681
Practice Address - Street 1:5640 READ BLVD
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70127-3140
Practice Address - Country:US
Practice Address - Phone:504-245-2440
Practice Address - Fax:504-245-4284
Is Sole Proprietor?:No
Enumeration Date:2016-06-09
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator