Provider Demographics
NPI:1316789290
Name:FLIPPIN, MICHELLE (PHD, SLP)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:
Last Name:FLIPPIN
Suffix:
Gender:F
Credentials:PHD, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:85 FAIRVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WEST KINGSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02892-1964
Mailing Address - Country:US
Mailing Address - Phone:401-824-6976
Mailing Address - Fax:
Practice Address - Street 1:85 FAIRVIEW DR
Practice Address - Street 2:
Practice Address - City:WEST KINGSTON
Practice Address - State:RI
Practice Address - Zip Code:02892-1964
Practice Address - Country:US
Practice Address - Phone:401-824-6976
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-11
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RISP01299235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist