Jillene Susag, Ed. S., NCSP
Psychologist, School in Dickinson, ND. Individual provider (NPI-1).
NPI number1982425609
StatusActive
Last updated in NPPESOct 24, 2024
Details
- NPI
- 1982425609
- Entity type
- Individual (NPI-1)
- Name
- Jillene Susag
- Credential
- Ed. S., NCSP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 24, 2024
- Certification date
- Oct 24, 2024
- Last updated
- Oct 24, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 103TS0200X | Psychologist, School | 417190 | ND | Yes |
Practice location
444 4th St WDickinson, ND 58601-4951
Phone 701-456-0002
Mailing address
444 4th St WDickinson, ND 58601-4951
Phone 701-456-0002
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