Provider Demographics
NPI:1871681916
Name:RIPPY, HEIDI NOELLE (MS,CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:NOELLE
Last Name:RIPPY
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:MS
Other - First Name:HEIDE
Other - Middle Name:NOELLE
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS,CCC-SLP
Mailing Address - Street 1:P.O. DRAWER 2109
Mailing Address - Street 2:
Mailing Address - City:RUSSELLVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72811-2109
Mailing Address - Country:US
Mailing Address - Phone:479-967-2322
Mailing Address - Fax:479-967-2876
Practice Address - Street 1:1500 CHERI WHITLOCK
Practice Address - Street 2:
Practice Address - City:SILOAM SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:72761-4220
Practice Address - Country:US
Practice Address - Phone:479-524-2456
Practice Address - Fax:479-373-1129
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2236235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR156443721Medicaid
12088242OtherASHA
AR2236OtherLICENSE NUMBER
AR5Y684OtherBC/BS