Individual
AMELIA L TIPPETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
120 STEVENS ST SW, GRAND RAPIDS, MI 49507-1526
(855) 832-6727
Mailing address
2225 ARGENTINA DR SE, GRAND RAPIDS, MI 49506-3549
(616) 425-1380
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81-0764147
—
MI
Enumeration date
07/27/2022
Last updated
07/27/2022
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