Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YP1600X | Pastoral Counselor | 885 | WV |
Y | 102L00000X | Psychologist | 885 | WV |
Y | 103T00000X | Psychologist | 885 | WV |
NPI | 1316946973 |
---|---|
Provider Name | Dr. Bridget D. Magnetti |
First Address | Martinsburg, WV 25402 |
Second Address | Martinsburg, WV 25401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2005 |
Last Update Date | 17/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3810001317 | (05) | WV |