Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | P1844 | TN |
N | 103T00000X | Psychologist | P1844 | TN |
N | 103TA0700X | Adult Development & Aging Psychologist | P1844 | TN |
Y | 103G00000X | Clinical Psychologist | P1844 | TN |
Y | 103TC0700X | Clinical Psychologist | P1844 | TN |
N | 103TC1900X | Counseling Psychologist | P1844 | TN |
N | 103TF0000X | Family Psychologist | P1844 | TN |
NPI | 1811035967 |
---|---|
Provider Name | Dr. Martha S Rubenstein |
First Address | Kingsport, TN 37660-4828 |
Second Address | Kingsport, TN 37660-4828 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 24/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
086618000 | MAGELLAN (01) | TN |
089489 | VALUE OPTIONS (01) | TN |
123121 | MHN (01) | TN |
283730 | BCBS VA (01) | TN |
3051273 | BCBS TN (01) | TN |
4522650 | AETNA (01) | TN |
9213177 | PHCS (01) | TN |
R70874 | (02) | TN |