Provider Demographics
NPI:1023081908
Name:CHUPELLA, MARY ANN (MA)
Entity type:Individual
Prefix:MRS
First Name:MARY ANN
Middle Name:
Last Name:CHUPELLA
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 1:540 BRIDLE PATH RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-3110
Mailing Address - Country:US
Mailing Address - Phone:610-691-3296
Mailing Address - Fax:
Practice Address - Street 1:35 E ELIZABETH AVE
Practice Address - Street 2:SUITE 27
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18018-6505
Practice Address - Country:US
Practice Address - Phone:610-691-1740
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC001703101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional