Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | PY 5901 | FL |
N | 103T00000X | Psychologist | PY 5901 | FL |
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
Y | 103G00000X | Clinical Psychologist | PY 5901 | FL |
Y | 103TC0700X | Clinical Psychologist | PY 5901 | FL |
N | 103TS0200X | School Psychologist |
NPI | 1174531420 |
---|---|
Provider Name | Dr. Gail J Purdy |
First Address | Homosassa, FL 34448-7312 |
Second Address | Homosassa, FL 34448-7312 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 29/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
689827196 | (05) | FL |