Provider Demographics
NPI:1871190223
Name:RIPPLE, JOANNA (LSW)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:RIPPLE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:
Other - Last Name:DIAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW
Mailing Address - Street 1:2730 PROGRESS PARK DR
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-2120
Mailing Address - Country:US
Mailing Address - Phone:330-554-2757
Mailing Address - Fax:
Practice Address - Street 1:2730 PROGRESS PARK DR
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-2120
Practice Address - Country:US
Practice Address - Phone:330-554-2757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2020-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.0801133104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker