Individual
SYLVIA MARIA CUPP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC, LCDC
Contact information
Practice address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 539-2644
Mailing address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 539-2644
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
18909
TX
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
9817
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760473607
—
TX
Enumeration date
10/31/2005
Last updated
06/22/2021
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