Healthcare Provider Details

I. General information

NPI: 1124292677
Provider Name (Legal Business Name): ROBIN JOY LIPKE PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2008
Last Update Date: 04/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NORTHERN CHEYENNE CLINIC HIGHWAY 39
LAME DEER MT
59043
US

IV. Provider business mailing address

PO BOX 397
COLSTRIP MT
59323-0397
US

V. Phone/Fax

Practice location:
  • Phone: 406-477-4514
  • Fax:
Mailing address:
  • Phone: 406-748-3147
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2987
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: