Provider Demographics
NPI:1952607723
Name:EPP, SUSANNA LEIGH LETOTO (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SUSANNA LEIGH
Middle Name:LETOTO
Last Name:EPP
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:SUSANNA LEIGH
Other - Middle Name:SUN LAI
Other - Last Name:LETOTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:32650 STATE ROUTE 20 STE E203
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-2686
Mailing Address - Country:US
Mailing Address - Phone:360-682-6499
Mailing Address - Fax:
Practice Address - Street 1:32650 STATE ROUTE 20 STE E203
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-2686
Practice Address - Country:US
Practice Address - Phone:360-682-6499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60547883103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical