Taub, Susan Ilene

Taub, Susan Ilene is an individual health care provider with primary practice located at 1604 E Oakland Ave , Johnson City TN 37601-2151. She recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as her primary health care specialty. Taub, Susan Ilene can be contacted via phone (423) 928-2222.

Contact Information

Primary practice address
1604 E Oakland Ave Johnson City TN 37601-2151
Phone: (423) 928-2222
Fax: (423) 926-5455
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X P0000001182 Tennessee

Profile Details

NPI number 1780660431
LBN Legal business name Taub, Susan Ilene
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 15th, 2005
Last updated Jul 8th, 2007 - about 17 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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Identifiers

StateTypeNumberIssuer
All States NPI 1780660431 NPPES
Other 0005354369 AETNA
Other 82899 AETNA
MEDICAID 3689675 AETNA
Other 014511 AETNA
Other 3689675 AETNA

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