Provider Demographics
NPI:1538503958
Name:RUPP, DYANN F (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DYANN
Middle Name:F
Last Name:RUPP
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4810 ELK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68516-3344
Mailing Address - Country:US
Mailing Address - Phone:402-450-7068
Mailing Address - Fax:
Practice Address - Street 1:4810 ELK RIDGE RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68516-3344
Practice Address - Country:US
Practice Address - Phone:402-450-7068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE963235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist