Provider Demographics
NPI:1659903417
Name:KIPNIS, JOAN KATZ (MA)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:KATZ
Last Name:KIPNIS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 MANSFIELD BLVD N
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-3607
Mailing Address - Country:US
Mailing Address - Phone:856-354-8755
Mailing Address - Fax:
Practice Address - Street 1:2112 PROVIDENCE AVE
Practice Address - Street 2:
Practice Address - City:CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19013-5507
Practice Address - Country:US
Practice Address - Phone:610-874-5366
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT00317L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist