Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC2200X | Clinical Child & Adolescent Psychologist | RC00055231 | WA |
NPI | 1124104484 |
---|---|
Provider Name | Andrew Shannon Neff |
First Address | Clinton, WA 98236-8411 |
Second Address | Clinton, WA 98236-8411 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/10/2006 |
Last Update Date | 08/07/2007 |