Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103TC1900X | Counseling Psychologist | ||
N | 103TH0100X | Health Service | ||
N | 103TM1800X | Intellectual & Developmental Disabilities |
NPI | 1003059726 |
---|---|
Provider Name | Dr. Michelle Hainesworth |
First Address | Wyomissing, PA 19610-4014 |
Second Address | Greensburg, PA 15601-3221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2009 |
Last Update Date | 18/03/2010 |