Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YP2500X | Professional Counselor | 000411 | NY |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 4045 | AZ |
N | 103G00000X | Clinical Psychologist | 4045 | AZ |
N | 103TC0700X | Clinical Psychologist | 4045 | AZ |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 4045 | AZ |
N | 103TS0200X | School Psychologist | AZ |
NPI | 1194855981 |
---|---|
Provider Name | Dr. Karlaye Dimanche-Rafindadi |
First Address | Sierra Vista, AZ 85635-2967 |
Second Address | Sierra Vista, AZ 85635-2967 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 18/10/2010 |