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General NPI Number Information
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NPI Number | 1295702033
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Entity Type | Individual
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Provider Name | HUBERTA L PHIPPS LCPC
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Gender | Female
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Dates
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Enumeration Date | 03/01/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1525 ADDISON AVE E 1369 E 16TH ST
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City | TWIN FALLS
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State | ID
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Zip | 83301
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Country | US
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Telephone | 208-734-4809
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Fax | 208-733-0120
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Provider Business Mailing Address
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Address Line | 1525 ADDISON AVE E
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City | TWIN FALLS
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State | ID
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Zip | 83301
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Country | US
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Telephone | 208-734-4809
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Fax | 208-733-0120
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCPC342
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License Number State | ID
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