Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PY6104 | FL |
N | 103T00000X | Psychologist | PY6104 | FL |
N | 102L00000X | Psychologist | PY6194 | FL |
N | 103T00000X | Psychologist | PY6194 | FL |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PY6194 | FL |
Y | 103G00000X | Clinical Psychologist | PY6194 | FL |
Y | 103TC0700X | Clinical Psychologist | PY6194 | FL |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | PY6194 | FL |
NPI | 1134100381 |
---|---|
Provider Name | Cheryl Jane Kasprzak |
First Address | Naples, FL 34116-6065 |
Second Address | Naples, FL 34104-6114 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2005 |
Last Update Date | 30/11/2012 |