Individual
SHAREE NICOLE CUPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP ASSISTANT
Contact information
Practice address
6530 HAWKS CREEK CT STE 107, FORT WORTH, TX 76114-1164
(817) 435-4631
Mailing address
4351 FM 1195, MINERAL WELLS, TX 76067-0731
(940) 745-0286
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
Primary
36165
TX
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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