Provider Demographics
NPI:1376702027
Name:CANUPP, AMY K (SLP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:K
Last Name:CANUPP
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2930 ALPINE FOREST CT
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28270-2298
Mailing Address - Country:US
Mailing Address - Phone:704-577-6436
Mailing Address - Fax:
Practice Address - Street 1:3315 SPRINGBANK LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28226-3197
Practice Address - Country:US
Practice Address - Phone:704-577-6436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-07
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6046235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist