Provider Demographics
NPI:1841497955
Name:LIPSCOMB, SAMMIE RISLEY (MCD,CCC,SLP)
Entity type:Individual
Prefix:MRS
First Name:SAMMIE
Middle Name:RISLEY
Last Name:LIPSCOMB
Suffix:
Gender:F
Credentials:MCD,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:PO BOX 47
Mailing Address - Street 2:
Mailing Address - City:TAMASSEE
Mailing Address - State:SC
Mailing Address - Zip Code:29686-0047
Mailing Address - Country:US
Mailing Address - Phone:864-944-7376
Mailing Address - Fax:
Practice Address - Street 1:1934 N PLEASANTBURG DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-4036
Practice Address - Country:US
Practice Address - Phone:864-236-1542
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC3163235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist