Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | PY00002546 | WA |
Y | 103G00000X | Clinical Psychologist | PY00002546 | WA |
Y | 103TC0700X | Clinical Psychologist | PY00002546 | WA |
N | 103TH0004X | Health Psychologist | PY00002546 | WA |
NPI | 1144478918 |
---|---|
Provider Name | Dr. Kelly M Carpenter |
First Address | Seattle, WA 98133-9010 |
Second Address | Seattle, WA 98133-9010 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2008 |
Last Update Date | 04/09/2008 |