Provider Demographics
NPI:1841743853
Name:PIPKORN, AMELYA L
Entity Type:Individual
Prefix:
First Name:AMELYA
Middle Name:L
Last Name:PIPKORN
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:N75W30363 COUNTY ROAD VV
Mailing Address - Street 2:
Mailing Address - City:HARTLAND
Mailing Address - State:WI
Mailing Address - Zip Code:53029-9530
Mailing Address - Country:US
Mailing Address - Phone:262-424-7266
Mailing Address - Fax:
Practice Address - Street 1:N75W30363 COUNTY ROAD VV
Practice Address - Street 2:
Practice Address - City:HARTLAND
Practice Address - State:WI
Practice Address - Zip Code:53029-9530
Practice Address - Country:US
Practice Address - Phone:262-424-7266
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-26
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst