Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 3049 | CA |
NPI | 1043795644 |
---|---|
Provider Name | Bobbie Renee Ables-Smith |
First Address | Lodi, CA 95240-3179 |
Second Address | Lodi, CA 95240-3179 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2018 |
Last Update Date | 28/09/2018 |