Provider Demographics
NPI:1154948768
Name:POPPLE, ROXANNE (PSY D)
Entity type:Individual
Prefix:DR
First Name:ROXANNE
Middle Name:
Last Name:POPPLE
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:803 E BOOT RD APT 200
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-1270
Mailing Address - Country:US
Mailing Address - Phone:570-690-0599
Mailing Address - Fax:
Practice Address - Street 1:312 HYDE PARK
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-6605
Practice Address - Country:US
Practice Address - Phone:215-345-5083
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-30
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS019038103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical