Provider Demographics
NPI:1538536081
Name:COPLAN, LUCIA (MSOT)
Entity type:Individual
Prefix:
First Name:LUCIA
Middle Name:
Last Name:COPLAN
Suffix:
Gender:F
Credentials:MSOT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 ESTHER DR
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-1056
Mailing Address - Country:US
Mailing Address - Phone:508-422-9962
Mailing Address - Fax:
Practice Address - Street 1:45 HOLLISTON ST
Practice Address - Street 2:
Practice Address - City:MEDWAY
Practice Address - State:MA
Practice Address - Zip Code:02053-1404
Practice Address - Country:US
Practice Address - Phone:508-533-6626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-31
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5983225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist