Provider Demographics
NPI:1598841751
Name:VAN RIPER, JUDITH (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:VAN RIPER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:952 WATTERS RD
Mailing Address - Street 2:
Mailing Address - City:HAYESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28904-9204
Mailing Address - Country:US
Mailing Address - Phone:828-389-4618
Mailing Address - Fax:
Practice Address - Street 1:952 WATTERS RD
Practice Address - Street 2:
Practice Address - City:HAYESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28904-9204
Practice Address - Country:US
Practice Address - Phone:828-389-4618
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP004166235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist