Provider Demographics
NPI:1386995579
Name:WIPPERT, ALLISON MALIK (CNIM)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:MALIK
Last Name:WIPPERT
Suffix:
Gender:F
Credentials:CNIM
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:CHRISTINE
Other - Last Name:MALIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNIM
Mailing Address - Street 1:25 HIGHLAND PARK VLG
Mailing Address - Street 2:SUITE 100-225
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205
Mailing Address - Country:US
Mailing Address - Phone:214-536-1647
Mailing Address - Fax:972-625-2884
Practice Address - Street 1:25 HIGHLAND PARK VLG STE 100-225
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205
Practice Address - Country:US
Practice Address - Phone:214-536-1647
Practice Address - Fax:972-625-2884
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other