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Individual

TARI D. CUPP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MCD, CCC-SLP

Contact information

Practice address
605 MULBERRY ST, BERNIE, MO 63822-9457
(573) 293-6256
(573) 293-6256
Mailing address
605 MULBERRY ST, BERNIE, MO 63822-9457
(573) 293-6256
(573) 293-6256

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
106742
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
465325801
MO
Enumeration date
04/01/2009
Last updated
04/01/2009
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