Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103G00000X | Clinical Psychologist | 32533 | TX |
Y | 103TC0700X | Clinical Psychologist | 32533 | TX |
NPI | 1003205071 |
---|---|
Provider Name | Dr. Nancy Sylvia L. Witt |
First Address | San Antonio, TX 78240-4801 |
Second Address | San Antonio, TX 78240-4801 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2015 |
Last Update Date | 22/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32533 | LICENSE (01) | TX |