Provider Demographics
NPI:1760519136
Name:KUPFERSMID, JOEL HOWARD (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:HOWARD
Last Name:KUPFERSMID
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1186 TEMPLE TRL
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-2239
Mailing Address - Country:US
Mailing Address - Phone:330-688-0889
Mailing Address - Fax:
Practice Address - Street 1:1186 TEMPLE TRL
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-2239
Practice Address - Country:US
Practice Address - Phone:330-688-0889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2555103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist