Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | PSY001981 | GA |
Y | 103TC0700X | Clinical Psychologist | PSY001981 | GA |
N | 102L00000X | Psychologist | 09724 | IA |
N | 103T00000X | Psychologist | 09724 | IA |
N | 102L00000X | Psychologist | PSY001981 | GA |
N | 103T00000X | Psychologist | PSY001981 | GA |
N | 103TH0100X | Health Service | 098191 | IA |
NPI | 1568558872 |
---|---|
Provider Name | Dr. Marla Beth Shapiro |
First Address | Grimes, IA 50111-5185 |
Second Address | Grimes, IA 50111-5185 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 28/03/2021 |