Susilo, Angela Wynonna
Susilo, Angela Wynonna is an sole proprietor health care provider with primary practice located at 3210 Shorewood Dr Apt 145 , Mercer Island WA 98040-3224. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Susilo, Angela Wynonna can be contacted via phone (331) 444-9206.Contact Information
Primary practice address
3210 Shorewood Dr Apt 145
Mercer Island WA 98040-3224
Phone: (331) 444-9206
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | MC61094941 | Washington |
Profile Details
| NPI number | 1831862598 |
|---|---|
| LBN Legal business name | Susilo, Angela Wynonna |
| Credentials | LMHCA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 28th, 2021 |
| Last updated | Aug 14th, 2021 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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