Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 1056 | KS |
Y | 103T00000X | Psychologist | 1056 | KS |
NPI | 1013130517 |
---|---|
Provider Name | Dr. Jane L. Tippet |
First Address | Manhattan, KS 66502-3415 |
Second Address | Manhattan, KS 66502-3415 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2007 |
Last Update Date | 15/06/2009 |