Doctor Name: | MR. ROBERT ARTHUR KIPPLEY |
NPI Number: | 1003963109 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MA, LP |
License Number: | LP2369 |
Business Practice Address: | 1919 University Ave W Suite 200 Saint Paul, MN - 551043453 |
Business Phone Number: | 6512667929 |
Business Fax Number: | 6512667850 |
Mailing Address: | 2459 Sunrise Dr, LITTLE CANADA |
State: | MN |
Postal Code: | 551171661 |
Phone Number: | 6514816902 |
Fax Number: | |
NPI Enumeration Date: | 01/04/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | LP2369 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |