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General NPI Number Information
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NPI Number | 1922570977
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Entity Type | Organization
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Legal Business Name | SUSANNA LEIGH L EPP PSYD
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Dates
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Enumeration Date | 12/31/2018
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Last Update Date | 06/17/2019
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Provider Practice Location Address
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Address Line | 640 E WHIDBEY AVE
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City | OAK HARBOR
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State | WA
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Zip | 98277-5901
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Country | US
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Telephone | 360-559-1446
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Fax |
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Provider Business Mailing Address
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Address Line | 10 LOUISE VIEW DR
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City | BELLINGHAM
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State | WA
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Zip | 98229-4419
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CLINICAL PSYCHOLOGIST
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Name | SUSANNA LEIGH L. EPP
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Credential | PSYD
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Telephone | 808-392-2098
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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