Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY1001024 | DC |
Y | 103T00000X | Psychologist | PSY1001024 | DC |
N | 103G00000X | Clinical Psychologist | PSY1001024 | DC |
N | 103TC0700X | Clinical Psychologist | PSY1001024 | DC |
N | 103TC1900X | Counseling Psychologist | LP5580 | MN |
NPI | 1114332509 |
---|---|
Provider Name | Dr. Davin Maijala |
First Address | Washington, DC 20036-1735 |
Second Address | Washington, DC 20036-1735 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2014 |
Last Update Date | 17/03/2018 |