Provider Demographics
NPI:1891944922
Name:KLIPP, RUTH ANN RAICHLE (MA, CCC-SP)
Entity type:Individual
Prefix:MRS
First Name:RUTH ANN
Middle Name:RAICHLE
Last Name:KLIPP
Suffix:
Gender:F
Credentials:MA, CCC-SP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 KINGWOOD PARK
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-5446
Mailing Address - Country:US
Mailing Address - Phone:845-462-5220
Mailing Address - Fax:845-463-0470
Practice Address - Street 1:195 KINGWOOD PARK
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-5446
Practice Address - Country:US
Practice Address - Phone:845-462-5220
Practice Address - Fax:845-463-0470
Is Sole Proprietor?:No
Enumeration Date:2008-09-12
Last Update Date:2008-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005532-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist