Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 011339 | NY |
N | 103T00000X | Psychologist | 011339 | NY |
N | 103G00000X | Clinical Psychologist | 584 | NE |
N | 103TC0700X | Clinical Psychologist | 584 | NE |
NPI | 1013068246 |
---|---|
Provider Name | Dr. Beth A Avolio |
First Address | Elkhorn, NE 68022-2234 |
Second Address | Elkhorn, NE 68022-2234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2007 |
Last Update Date | 08/07/2007 |