Provider Demographics
NPI:1770026890
Name:BUPP, ROWAN (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:ROWAN
Middle Name:
Last Name:BUPP
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 1:74 E 18TH AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4081
Mailing Address - Country:US
Mailing Address - Phone:412-499-9185
Mailing Address - Fax:884-899-8398
Practice Address - Street 1:74 E 18TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-4081
Practice Address - Country:US
Practice Address - Phone:541-249-9918
Practice Address - Fax:888-489-9839
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR15679235Z00000X
015679235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist