Individual
SPENCER CUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
860 HAINES, LIBERTY, MO 64068-1006
(816) 429-5039
Mailing address
105 SW EAGLES PKWY, GRAIN VALLEY, MO 64029-8512
(816) 265-1170
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
RBT-24-365017
MO
Other
Enumeration date
07/29/2024
Last updated
07/29/2024
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