Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
Y | 103G00000X | Clinical Psychologist | PSY003668 | GA |
Y | 103TC0700X | Clinical Psychologist | PSY003668 | GA |
NPI | 1003192832 |
---|---|
Provider Name | Dr. Deauna Venise Webb |
First Address | Springfield, MA 01103-2215 |
Second Address | Greenfield, MA 01301-2457 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2011 |
Last Update Date | 18/05/2013 |