Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1083800940 |
---|---|
Provider Name | Athina Georgiou |
First Address | Pittsburg, CA 94565-3937 |
Second Address | Pittsburg, CA 94565-3937 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/09/2007 |
Last Update Date | 24/09/2007 |