Provider Demographics
NPI:1417537911
Name:CUPPETT, SOPHIE E (SLP)
Entity type:Individual
Prefix:
First Name:SOPHIE
Middle Name:E
Last Name:CUPPETT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:SOPHIE
Other - Middle Name:ELISE
Other - Last Name:COMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RBT
Mailing Address - Street 1:1 BRONZE POINTE BLVD STE 2A
Mailing Address - Street 2:
Mailing Address - City:SWANSEA
Mailing Address - State:IL
Mailing Address - Zip Code:62226-1045
Mailing Address - Country:US
Mailing Address - Phone:833-587-1784
Mailing Address - Fax:
Practice Address - Street 1:1 BRONZE POINTE BLVD STE 2A
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226-1045
Practice Address - Country:US
Practice Address - Phone:833-587-1784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist