MEDICARE: LILY RIPPEY

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	235Z00000X	Speech-Language Pathologist	051051	RI

General Provider Information

NPI Number	:	1013191410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LILY RIPPEY

Provider Business Mailing Address
First Line	:	20 SHELLDRAKE RD
Second Line	:
City	:	WAKEFIELD
State	:	RI
Zip	:	02879-6506
Country	:	US
Telephone Number	:	401-782-9521
Fax Number	:

Provider Business Practice Location Address
First Line	:	850 STONY FORT RD
Second Line	:
City	:	SAUNDERSTOWN
State	:	RI
Zip	:	02874-1003
Country	:	US
Telephone Number	:	401-783-8282
Fax Number	:

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

Provider Enumeration Date	:	12/20/2007
Last Update Date	:	12/20/2007

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Directions to “ LILY RIPPEY ” Practice Location

Language	Start Address	Practice Location

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