Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PY00000434 | WA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PY00000434 | WA |
N | 103G00000X | Clinical Psychologist | PY00000434 | WA |
N | 103TC0700X | Clinical Psychologist | PY00000434 | WA |
NPI | 1487779120 |
---|---|
Provider Name | Dr. Judy Walker Weber |
First Address | Vancouver, WA 98661-4332 |
Second Address | Vancouver, WA 98661-4332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S27236 | (02) |