Individual
CONNIE TIPTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
113 LEGENDS RIDGE DR, LEBANON, TN 37090-1565
(800) 259-9897
Mailing address
113 LEGENDS RIDGE DR, LEBANON, TN 37090
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
5863
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68144
TRIAGE ZIP CODE
—
Enumeration date
01/22/2014
Last updated
01/22/2014
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