Provider Demographics
NPI:1912543042
Name:PIPPER, NOAH
Entity Type:Individual
Prefix:
First Name:NOAH
Middle Name:
Last Name:PIPPER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2279 SHAWNEE TRL
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-2527
Mailing Address - Country:US
Mailing Address - Phone:517-897-3562
Mailing Address - Fax:
Practice Address - Street 1:2279 SHAWNEE TRL
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-2527
Practice Address - Country:US
Practice Address - Phone:517-897-3562
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst