Tari D. Cupp, MCD, CCC-SLP
Individual provider Active NPI Speech-Language Pathologist · Bernie, MO
NPI 1669614822 · NPPES record last updated Apr 1, 2009
Key facts
- NPI
- 1669614822
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 106742 (MO)
- Practice address
- 605 Mulberry St
Bernie, MO 63822-9457 - Phone
- (573) 293-6256
- Fax
- (573) 293-6256
- NPI assigned
- Apr 1, 2009
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 106742 | MO | MD | Speech-Language Pathologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 106742 | MO | Yes |
Addresses
Primary practice location
605 Mulberry St
Bernie, MO 63822-9457
Mailing address
605 Mulberry St
Bernie, MO 63822-9457
Phone (573) 293-6256
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 465325801 | Medicaid | MO |
Other providers in Bernie, MO
- Amanda Elaine Bader
- Bernie R-Xiii School District
- Cara M Dillinger
- Brandy Susanne Heinley
- Karaline Alynn Keirsey
- Shelby Lawrence
- Katrina Leanne Miller
All providers in Bernie, MO · Speech-Language Pathologist in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.