Provider Demographics
NPI:1841347853
Name:KIPP, BILLIE JO (PHD)
Entity type:Individual
Prefix:DR
First Name:BILLIE
Middle Name:JO
Last Name:KIPP
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9828 DAVENPORT ST NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-4256
Mailing Address - Country:US
Mailing Address - Phone:505-890-8227
Mailing Address - Fax:
Practice Address - Street 1:9828 DAVENPORT ST NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-4256
Practice Address - Country:US
Practice Address - Phone:505-890-8227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health