Provider Demographics
NPI:1477857191
Name:TIPPIT, LEIGH ANN
Entity Type:Individual
Prefix:
First Name:LEIGH ANN
Middle Name:
Last Name:TIPPIT
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 1:108127 S 4801 RD
Mailing Address - Street 2:
Mailing Address - City:MULDROW
Mailing Address - State:OK
Mailing Address - Zip Code:74948-7689
Mailing Address - Country:US
Mailing Address - Phone:918-875-8935
Mailing Address - Fax:
Practice Address - Street 1:108127 S 4801 RD
Practice Address - Street 2:
Practice Address - City:MULDROW
Practice Address - State:OK
Practice Address - Zip Code:74948-7689
Practice Address - Country:US
Practice Address - Phone:918-875-8935
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-10
Last Update Date:2011-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health