Provider Demographics
NPI:1679702104
Name:PEPE, ROXANNE MARIE
Entity type:Individual
Prefix:MRS
First Name:ROXANNE
Middle Name:MARIE
Last Name:PEPE
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 1:135 CENTER ST
Mailing Address - Street 2:APT. E
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-1840
Mailing Address - Country:US
Mailing Address - Phone:774-526-1275
Mailing Address - Fax:
Practice Address - Street 1:385 COURT ST
Practice Address - Street 2:SUITE 102
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-7304
Practice Address - Country:US
Practice Address - Phone:508-830-3444
Practice Address - Fax:508-746-3944
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor