Provider Demographics
NPI:1134369614
Name:TIPPITT, REBECCA JOY (CCC/SLP)
Entity type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:JOY
Last Name:TIPPITT
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3800 ENCHANTED SKY ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-8221
Mailing Address - Country:US
Mailing Address - Phone:609-613-0795
Mailing Address - Fax:
Practice Address - Street 1:2850 W HORIZON RIDGE PKWY STE 320
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4395
Practice Address - Country:US
Practice Address - Phone:702-564-4116
Practice Address - Fax:702-932-2403
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-24
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS00474300235Z00000X
NVSP2179235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist