Provider Demographics
NPI:1568586345
Name:PHIPPS, MICHELLE COX (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:COX
Last Name:PHIPPS
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 1:297 PHIPPS DAIRY RD
Mailing Address - Street 2:
Mailing Address - City:PINEY CREEK
Mailing Address - State:NC
Mailing Address - Zip Code:28663-9108
Mailing Address - Country:US
Mailing Address - Phone:336-359-8411
Mailing Address - Fax:
Practice Address - Street 1:2359 HIGHWAY 105
Practice Address - Street 2:CDSA OF THE BLUE RIDGE
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-7814
Practice Address - Country:US
Practice Address - Phone:336-982-4754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5047235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1384ROtherBLUE CROSS BLUE SHIELD