Individual
DR. MARIELIS JEPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
1280 S KIHEI RD, SUITE 302 AZEKA MAKAI SHOPPING CENTER, KIHEI, HI 96753-8240
(808) 875-8737
Mailing address
PO BOX 724, KIHEI, HI 96753-0724
(808) 875-8737
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
608
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
539611
—
HI
Enumeration date
05/28/2006
Last updated
10/04/2007
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