Provider Demographics
NPI:1306679915
Name:RUPE, ELLA PATRICIA
Entity type:Individual
Prefix:
First Name:ELLA
Middle Name:PATRICIA
Last Name:RUPE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14540 S 302ND EAST AVE
Mailing Address - Street 2:
Mailing Address - City:COWETA
Mailing Address - State:OK
Mailing Address - Zip Code:74429-7845
Mailing Address - Country:US
Mailing Address - Phone:918-486-6103
Mailing Address - Fax:
Practice Address - Street 1:14540 S 302ND EAST AVE
Practice Address - Street 2:
Practice Address - City:COWETA
Practice Address - State:OK
Practice Address - Zip Code:74429-7845
Practice Address - Country:US
Practice Address - Phone:918-486-2186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKCF676235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist