Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 3896 | AZ |
Y | 103TC0700X | Clinical Psychologist | 3896 | AZ |
NPI | 1013161462 |
---|---|
Provider Name | Dr. Mayday R. Levine |
First Address | Tucson, AZ 85713-3353 |
Second Address | Tucson, AZ 85713-3353 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2008 |
Last Update Date | 12/11/2008 |