Individual
NOELLE E CUPP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1828 DEXTER ST, NEW LONDON, WI 54961-2522
(920) 982-4009
Mailing address
1828 DEXTER ST, NEW LONDON, WI 54961-2522
(920) 982-4009
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
4802-027
WI
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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