Provider Demographics
NPI:1326739038
Name:KUPIS, SOFIYA
Entity Type:Individual
Prefix:
First Name:SOFIYA
Middle Name:
Last Name:KUPIS
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 1:430 BUCKINGHAM RD APT 2022
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75081-5767
Mailing Address - Country:US
Mailing Address - Phone:646-750-5259
Mailing Address - Fax:
Practice Address - Street 1:8733 LA PRADA DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-5036
Practice Address - Country:US
Practice Address - Phone:214-321-0156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX108603104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker