| Doctor Name: | DR. MARIELIS JEPSON |
| NPI Number: | 1396792966 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSY.D. |
| License Number: | 608 |
| Business Practice Address: | 1280 S Kihei Rd Suite 302 Azeka Makai Shopping Center Kihei, HI - 967538240 |
| Business Phone Number: | 8088758737 |
| Business Fax Number: | |
| Mailing Address: | Po Box 724, KIHEI |
| State: | HI |
| Postal Code: | 967530724 |
| Phone Number: | 8088758737 |
| Fax Number: | |
| NPI Enumeration Date: | 05/28/2006 |
| NPI Last Update Date: | 10/04/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC0700X |
| License Number: | 608 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | HI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | |