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Individual

ANA CUPP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, CSW-INTERN

Contact information

Practice address
11230 SW 90TH AVE, PORTLAND, OR 97223-6423
(775) 830-3568
Mailing address
11230 SW 90TH AVE, PORTLAND, OR 97223-6423
(775) 830-3568

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
8442-S
NV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00001142210
NV
Enumeration date
09/30/2021
Last updated
01/10/2022
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