Provider Demographics
NPI:1558529727
Name:LIPPERT, JOCELYN S (ST)
Entity Type:Individual
Prefix:
First Name:JOCELYN
Middle Name:S
Last Name:LIPPERT
Suffix:
Gender:F
Credentials:ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 WESTFALIAN TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-1967
Mailing Address - Country:US
Mailing Address - Phone:512-587-5671
Mailing Address - Fax:512-535-6786
Practice Address - Street 1:2100 WESTFALIAN TRL
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78732-1967
Practice Address - Country:US
Practice Address - Phone:512-587-5671
Practice Address - Fax:512-535-6786
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2008-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100986235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist