Provider Demographics
NPI:1972005866
Name:LIPPMANN, GLENDA KATHRYN (PHD)
Entity Type:Individual
Prefix:DR
First Name:GLENDA
Middle Name:KATHRYN
Last Name:LIPPMANN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12265 W BAYAUD AVE STE 235
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80228-2116
Mailing Address - Country:US
Mailing Address - Phone:303-929-5941
Mailing Address - Fax:
Practice Address - Street 1:12265 W BAYAUD AVE STE 235
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80228-2116
Practice Address - Country:US
Practice Address - Phone:303-929-5941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-06
Last Update Date:2018-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY3844103TR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TR0400XBehavioral Health & Social Service ProvidersPsychologistRehabilitation