Provider Demographics
NPI:1750608659
Name:CUPP, MELISSA ANN
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ANN
Last Name:CUPP
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 1:35 DIXON ST
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840-4038
Mailing Address - Country:US
Mailing Address - Phone:401-316-5844
Mailing Address - Fax:
Practice Address - Street 1:10 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-2130
Practice Address - Country:US
Practice Address - Phone:508-678-2833
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-01
Last Update Date:2010-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health