Provider Demographics
NPI:1780212837
Name:RIPP, FLORA
Entity Type:Individual
Prefix:
First Name:FLORA
Middle Name:
Last Name:RIPP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6110 N PORT WASHINGTON RD
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53217-4308
Mailing Address - Country:US
Mailing Address - Phone:414-962-1000
Mailing Address - Fax:
Practice Address - Street 1:6520 W LAYTON AVE STE 206
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-4500
Practice Address - Country:US
Practice Address - Phone:856-481-2865
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100098537Medicaid