Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PY134 | NV |
Y | 103T00000X | Psychologist | PY134 | NV |
N | 103G00000X | Clinical Psychologist | PY134 | NV |
N | 103TC0700X | Clinical Psychologist | PY134 | NV |
N | 103TC1900X | Counseling Psychologist | PY134 | NV |
NPI | 1073666509 |
---|---|
Provider Name | Dr. Patricia A White |
First Address | Las Vegas, NV 89137-0286 |
Second Address | Las Vegas, NV 89128-0845 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2007 |
Last Update Date | 25/09/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2602064 | (05) | NV |
S10356 | (02) | NV |