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General NPI Number Information
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NPI Number | 1649689076
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Entity Type | Organization
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Legal Business Name | CUPPETT PSYCHOLOGY, PLLC
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Dates
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Enumeration Date | 08/11/2014
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Last Update Date | 08/11/2014
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Provider Practice Location Address
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Address Line | 320 WESTWAY PL SUITE 547
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City | ARLINGTON
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State | TX
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Zip | 76018-5245
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Country | US
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Telephone | 817-375-8890
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 174541
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City | ARLINGTON
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State | TX
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Zip | 76003-4541
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Country | US
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Telephone | 817-375-8890
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOLOGIST
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Name | DR. PAUL RICHARD CUPPETT
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Credential | PSY.D.
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Telephone | 817-375-8890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 32661
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License Number State | TX
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