Provider Demographics
NPI:1134987159
Name:KNUPP, CINDY (SLPA)
Entity type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:KNUPP
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 ROLLING MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61114-7509
Mailing Address - Country:US
Mailing Address - Phone:630-776-8604
Mailing Address - Fax:
Practice Address - Street 1:4215 ROLLING MEADOW LN
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61114-7509
Practice Address - Country:US
Practice Address - Phone:630-776-8604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MESAS40662355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant