Provider Demographics
NPI:1902616030
Name:WHIPPS, EMILY
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:WHIPPS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2419 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEVIDEO
Mailing Address - State:MN
Mailing Address - Zip Code:56265-2619
Mailing Address - Country:US
Mailing Address - Phone:320-321-1484
Mailing Address - Fax:320-877-9088
Practice Address - Street 1:2419 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:MONTEVIDEO
Practice Address - State:MN
Practice Address - Zip Code:56265-2619
Practice Address - Country:US
Practice Address - Phone:320-321-1484
Practice Address - Fax:320-877-9088
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician