Provider Demographics
NPI:1891954798
Name:RIPPY, DANA W (GSW)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:W
Last Name:RIPPY
Suffix:
Gender:F
Credentials:GSW
Other - Prefix:
Other - First Name:DANA
Other - Middle Name:M
Other - Last Name:DAUZAT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:GSW
Mailing Address - Street 1:1888 HIGHWAY 1241
Mailing Address - Street 2:
Mailing Address - City:DRY PRONG
Mailing Address - State:LA
Mailing Address - Zip Code:71423-3441
Mailing Address - Country:US
Mailing Address - Phone:318-640-0032
Mailing Address - Fax:
Practice Address - Street 1:2495 SHREVEPORT HWY
Practice Address - Street 2:
Practice Address - City:PINEVILLE
Practice Address - State:LA
Practice Address - Zip Code:71360-4044
Practice Address - Country:US
Practice Address - Phone:318-473-0010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9003104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker