Provider Demographics
NPI:1760188817
Name:TSCHUPP, ERYN (BCBA)
Entity type:Individual
Prefix:
First Name:ERYN
Middle Name:
Last Name:TSCHUPP
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 WESLEY ST
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-3044
Mailing Address - Country:US
Mailing Address - Phone:248-469-7769
Mailing Address - Fax:
Practice Address - Street 1:910 SPRING ST
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2881
Practice Address - Country:US
Practice Address - Phone:248-469-7769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-31
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1068-140103K00000X
MI7401001994103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst