Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 854 | LA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 854 | LA |
Y | 103G00000X | Clinical Psychologist | 854 | LA |
Y | 103TC0700X | Clinical Psychologist | 854 | LA |
N | 103TC1900X | Counseling Psychologist | 854 | LA |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 854 | LA |
N | 103TF0000X | Family Psychologist | 854 | LA |
NPI | 1396017778 |
---|---|
Provider Name | Dr. Amy L. Copeland |
First Address | Baton Rouge, LA 70806-6511 |
Second Address | Baton Rouge, LA 70806-6511 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2012 |
Last Update Date | 01/02/2012 |