Provider Demographics
NPI:1609200179
Name:LEUPITZ, MICHELLE ERIN
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ERIN
Last Name:LEUPITZ
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 1:220 15TH ST SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-4204
Mailing Address - Country:US
Mailing Address - Phone:503-363-7261
Mailing Address - Fax:
Practice Address - Street 1:220 15TH ST SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4204
Practice Address - Country:US
Practice Address - Phone:503-363-7261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker