MEDICARE: DR. JULIE DENISE RIPPETH PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103G00000X	Clinical Neuropsychologist	2933	CO

General Provider Information

NPI Number	:	1518902402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIE DENISE RIPPETH PH.D.

Provider Business Mailing Address
First Line	:	4820 RUSINA RD STE C
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-8127
Country	:	US
Telephone Number	:	720-339-1931
Fax Number	:	866-830-8582

Provider Business Practice Location Address
First Line	:	4820 RUSINA RD STE C
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80907-8127
Country	:	US
Telephone Number	:	720-339-1931
Fax Number	:	866-830-8582

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2006
Last Update Date	:	08/17/2018

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