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General NPI Number Information
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NPI Number | 1780961425
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Entity Type | Organization
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Legal Business Name | EMPORIA PSYCHOLOGICAL SERVICES INC
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Dates
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Enumeration Date | 11/09/2011
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Last Update Date | 02/11/2025
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Provider Practice Location Address
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Address Line | 1402 EXCHANGE CT
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City | EMPORIA
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State | KS
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Zip | 66801-5272
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Country | US
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Telephone | 620-342-1998
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Fax |
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Provider Business Mailing Address
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Address Line | 1402 EXCHANGE CT
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City | EMPORIA
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State | KS
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Zip | 66801-5272
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Country | US
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Telephone | 620-481-0100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | TIMOTHY STEVEN SIPPOLA
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Credential | PHD
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Telephone | 620-342-1998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 0523
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License Number State | KS
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