Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 1964 | WA |
NPI | 1063557080 |
---|---|
Provider Name | Dr. Ben Neal |
First Address | Kirkland, WA 98033-6162 |
Second Address | Kirkland, WA 98033-6162 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 08/07/2007 |