Individual
MRS. HEATHER CUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
723 EMORY VALLEY ROAD, OAK RIDGE, TN 37830
(419) 367-5926
Mailing address
7735 VILLAGE DR, KNOXVILLE, TN 37919-4724
(419) 367-5926
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
LSW0000010112
TN
104100000X
Social Worker
S 1500121
OH
1041C0700X
Clinical Social Worker
Primary
7022
TN
Other
Enumeration date
04/23/2015
Last updated
01/31/2020
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