Provider Demographics
NPI:1427241769
Name:BIPPERT, KASSI LETITIA (COTA)
Entity type:Individual
Prefix:MISS
First Name:KASSI
Middle Name:LETITIA
Last Name:BIPPERT
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10515 GULFDALE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-3602
Mailing Address - Country:US
Mailing Address - Phone:210-340-2627
Mailing Address - Fax:210-340-6437
Practice Address - Street 1:10515 GULFDALE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-3602
Practice Address - Country:US
Practice Address - Phone:210-340-2627
Practice Address - Fax:210-340-6437
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX403562224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant