Healthcare Provider Details

I. General information

NPI: 1518902402
Provider Name (Legal Business Name): JULIE DENISE RIPPETH PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4820 RUSINA RD STE C
COLORADO SPRINGS CO
80907-8127
US

IV. Provider business mailing address

4820 RUSINA RD STE C
COLORADO SPRINGS CO
80907-8127
US

V. Phone/Fax

Practice location:
  • Phone: 720-339-1931
  • Fax: 866-830-8582
Mailing address:
  • Phone: 720-339-1931
  • Fax: 866-830-8582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License Number2933
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: