Provider Demographics
NPI:1114350915
Name:TRIPP, REBEKAH LEIGH (AUD)
Entity Type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:LEIGH
Last Name:TRIPP
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:938 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:LOUDON
Mailing Address - State:TN
Mailing Address - Zip Code:37774-1341
Mailing Address - Country:US
Mailing Address - Phone:658-229-6230
Mailing Address - Fax:
Practice Address - Street 1:938 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:LOUDON
Practice Address - State:TN
Practice Address - Zip Code:37774-1341
Practice Address - Country:US
Practice Address - Phone:658-229-6230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-15
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1641237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN1641OtherSTATE LICENSE