Provider Demographics
NPI:1104307313
Name:HIPLEY, LAURA ROBERTSON
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ROBERTSON
Last Name:HIPLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:990 KRAMERIA ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80220-4617
Mailing Address - Country:US
Mailing Address - Phone:720-226-5582
Mailing Address - Fax:
Practice Address - Street 1:1633 FILLMORE ST STE 390
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-1586
Practice Address - Country:US
Practice Address - Phone:720-226-5582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-25
Last Update Date:2018-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMFT.0001536106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist