Provider Demographics
NPI:1598812539
Name:DUPCAK, SANDRA LEIGH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SANDRA
Middle Name:LEIGH
Last Name:DUPCAK
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1234
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01701-1234
Mailing Address - Country:US
Mailing Address - Phone:508-879-5885
Mailing Address - Fax:
Practice Address - Street 1:4 CALIFORNIA AVE STE 501
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01701-8867
Practice Address - Country:US
Practice Address - Phone:508-879-5885
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7850103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical