Provider Demographics
NPI:1689933640
Name:LIPMAN, HEIDI RAPPAPORT (SLP)
Entity Type:Individual
Prefix:
First Name:HEIDI
Middle Name:RAPPAPORT
Last Name:LIPMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2983 RIVERGREEN LN SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-8547
Mailing Address - Country:US
Mailing Address - Phone:770-265-7692
Mailing Address - Fax:
Practice Address - Street 1:2983 RIVERGREEN LN SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-8547
Practice Address - Country:US
Practice Address - Phone:770-265-7692
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-11
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GASLP001296235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist