Provider Demographics
NPI:1588404842
Name:SHIPP, LILA JOY (RBT)
Entity type:Individual
Prefix:
First Name:LILA
Middle Name:JOY
Last Name:SHIPP
Suffix:
Gender:F
Credentials:RBT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HIGHWOOD CT # M330
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-7028
Mailing Address - Country:US
Mailing Address - Phone:615-818-6682
Mailing Address - Fax:
Practice Address - Street 1:200 HIGHWOOD CT # M330
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-7028
Practice Address - Country:US
Practice Address - Phone:615-818-6682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician