Provider Demographics
NPI:1184734253
Name:RIPPENTROP, ANNE ELIZABETH (PHD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:ELIZABETH
Last Name:RIPPENTROP
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 1:1462 TRAIL BEND DR NW
Mailing Address - Street 2:
Mailing Address - City:SWISHER
Mailing Address - State:IA
Mailing Address - Zip Code:52338
Mailing Address - Country:US
Mailing Address - Phone:319-558-8852
Mailing Address - Fax:
Practice Address - Street 1:221 E COLLEGE ST
Practice Address - Street 2:SUITE 211; EASTWIND HEALING CENTER
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240
Practice Address - Country:US
Practice Address - Phone:319-337-3313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA00988103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
11527OtherBLUE CROSS/BLUE SHIELD