Provider Demographics
NPI:1871047506
Name:NIPAPE, PATRICE (MPH, BHT)
Entity type:Individual
Prefix:MR
First Name:PATRICE
Middle Name:
Last Name:NIPAPE
Suffix:
Gender:M
Credentials:MPH, BHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9431 W VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-4433
Mailing Address - Country:US
Mailing Address - Phone:602-544-6075
Mailing Address - Fax:
Practice Address - Street 1:6238 W SOUTHGATE ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85043-1908
Practice Address - Country:US
Practice Address - Phone:602-544-6075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-10
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)