Individual
TIMOTHY SIPPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1402 EXCHANGE CT, EMPORIA, KS 66801-5272
(620) 481-0100
Mailing address
1402 EXCHANGE CT, EMPORIA, KS 66801-5272
(620) 342-1998
(620) 342-1998
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
00523
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
119025
BC & BS OF KS
KS
01
—
48-1212043
AETNA 60054
KS
01
—
P00285242
RAIL ROAD MEDICARE
KS
Enumeration date
09/29/2006
Last updated
02/06/2025
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