Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TB0200X | Cognitive & Behavioral Psychologist | PY00001023 | WA |
NPI | 1174630719 |
---|---|
Provider Name | Dr. Barry Wolborsky |
First Address | Bellevue, WA 98005-2644 |
Second Address | Bellevue, WA 98005-2644 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2006 |
Last Update Date | 08/07/2007 |