Provider Demographics
NPI:1649822842
Name:RUPEL, KERRAH CUTTER (BCBA LBA-AZ)
Entity type:Individual
Prefix:MRS
First Name:KERRAH
Middle Name:CUTTER
Last Name:RUPEL
Suffix:
Gender:F
Credentials:BCBA LBA-AZ
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9552 E THOMAS PL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85748-8146
Mailing Address - Country:US
Mailing Address - Phone:520-260-5193
Mailing Address - Fax:
Practice Address - Street 1:7770 E WRIGHTSTOWN RD
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85715-4330
Practice Address - Country:US
Practice Address - Phone:520-260-5193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ103K00000X
AZSLPA117262355S0801X
AZBEH-001432103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant