Provider Demographics
NPI:1033468608
Name:CUPER, PRUDENCE FRANCES (PHD)
Entity Type:Individual
Prefix:DR
First Name:PRUDENCE
Middle Name:FRANCES
Last Name:CUPER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5007 SOUTHPARK DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-7739
Mailing Address - Country:US
Mailing Address - Phone:919-402-7987
Mailing Address - Fax:
Practice Address - Street 1:5007 SOUTHPARK DR
Practice Address - Street 2:SUITE 250
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-7739
Practice Address - Country:US
Practice Address - Phone:919-402-7987
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-29
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC102971103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical