Individual
KIMBERLY ALEXIS LIPPOLDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BCBA
Contact information
Practice address
13905 TECHNOLOGY DR STE A1, OKLAHOMA CITY, OK 73134-1054
(405) 455-6868
Mailing address
13301 SW 2ND TER, YUKON, OK 73099-7173
(405) 664-1288
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
1-21-51557
OK
106S00000X
Behavior Technician
RBT-19-103790
OK
Other
Enumeration date
11/01/2019
Last updated
05/02/2023
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