Doctor Name: | SUSAN SIPLE |
NPI Number: | 1255485934 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | RC00054569 |
Business Practice Address: | 1007 Koala Ave Omak, WA - 988419247 |
Business Phone Number: | 5098266191 |
Business Fax Number: | |
Mailing Address: | Po Box 411, OMAK |
State: | WA |
Postal Code: | 988410411 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/22/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | RC00054569 |
Healthcare Provider Taxonomy: (Secondary) | X |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |