Provider Demographics
NPI:1538948559
Name:CUPIT, ALISON M (SPEECH PATHOLOGIST)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:M
Last Name:CUPIT
Suffix:
Gender:F
Credentials:SPEECH PATHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2425 POOLE RD
Mailing Address - Street 2:
Mailing Address - City:VIDALIA
Mailing Address - State:LA
Mailing Address - Zip Code:71373-5737
Mailing Address - Country:US
Mailing Address - Phone:160-180-7966
Mailing Address - Fax:
Practice Address - Street 1:4358 HIGHWAY 84 W
Practice Address - Street 2:
Practice Address - City:VIDALIA
Practice Address - State:LA
Practice Address - Zip Code:71373-3353
Practice Address - Country:US
Practice Address - Phone:318-336-4226
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA3703235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist