Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 017163 | NY |
N | 103G00000X | Clinical Psychologist | 017163 | NY |
N | 103TC0700X | Clinical Psychologist | 017163 | NY |
Y | 103G00000X | Clinical Psychologist | 4093 | AZ |
Y | 103TC0700X | Clinical Psychologist | 4093 | AZ |
N | 103TH0004X | Health Psychologist | 017163 | NY |
NPI | 1356540173 |
---|---|
Provider Name | Dr. Mindy Beth Lipson |
First Address | Goodyear, AZ 85395-9000 |
Second Address | Goodyear, AZ 85395-9000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/07/2007 |
Last Update Date | 31/01/2011 |