Individual
ALLISON F LIPPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2924 SACRAMENTO ST, SAINT JOSEPH, MO 64507-1844
(816) 617-3831
Mailing address
2924 SACRAMENTO ST, SAINT JOSEPH, MO 64507-1844
(816) 617-3831
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4775
—
MO
Enumeration date
01/31/2019
Last updated
01/31/2019
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