| Doctor Name: | MRS. ALICE IPPOLITO |
| NPI Number: | 1184648677 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.A. |
| License Number: | 2003032240 |
| Business Practice Address: | 343 S Kirkwood Rd Suite 200 Kirkwood, MO - 631226195 |
| Business Phone Number: | 3142063400 |
| Business Fax Number: | |
| Mailing Address: | 1430 Olive St, Suite 400 SAINT LOUIS |
| State: | MO |
| Postal Code: | 631032303 |
| Phone Number: | 3142063418 |
| Fax Number: | |
| NPI Enumeration Date: | 07/27/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 2003032240 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |