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NPI Code Detail

MEDICARE: MRS. KERRAH CUTTER RUPEL BCBA LBA-AZ

MEDICARE: MRS. KERRAH CUTTER RUPEL BCBA LBA-AZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103K00000XBehavior AnalystAZ
22355S0801XSpeech-Language AssistantSLPA11726AZ
3103K00000XBehavior AnalystBEH-001432AZ

General Provider Information

NPI Number : 1649822842
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KERRAH CUTTER RUPEL BCBA LBA-AZ
Provider Business Mailing Address
First Line : 9552 E THOMAS PL
Second Line :
City : TUCSON
State : AZ
Zip : 85748-8146
Country : US
Telephone Number : 520-260-5193
Fax Number :
Provider Business Practice Location Address
First Line : 7770 E WRIGHTSTOWN RD
Second Line :
City : TUCSON
State : AZ
Zip : 85715-4330
Country : US
Telephone Number : 520-260-5193
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/09/2019
Last Update Date : 10/09/2024

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