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Individual

MRS. JOANNA LEIGH CUPP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MS, RD, LDN

Contact information

Practice address
106 NORTH CARAWAY, EUGENE SMITH ROOM 410, STATE UNIVERSITY, AR 72467-7246
(870) 680-8295
Mailing address
106 NORTH CARAWAY, EUGENE SMITH ROOM 410, STATE UNIVERSITY, AR 72467
(870) 680-8295

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
164.005327
IL

Other

Enumeration date
01/20/2012
Last updated
09/09/2020
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