Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | WV |
NPI | 1003088493 |
---|---|
Provider Name | Lisa Kathleen Lepsh |
First Address | Philippi, WV 26416-1150 |
Second Address | Philippi, WV 26416-1150 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2008 |
Last Update Date | 26/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0166426000 | (05) | WV |