Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 3366 | NC |
Y | 103T00000X | Psychologist | 3366 | NC |
N | 103TA0700X | Adult Development & Aging Psychologist | 3366 | NC |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 3366 | NC |
N | 103G00000X | Clinical Psychologist | 3366 | NC |
N | 103TC0700X | Clinical Psychologist | 3366 | NC |
N | 103TC1900X | Counseling Psychologist | 3366 | NC |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 3366 | NC |
N | 103TF0000X | Family Psychologist | 3366 | NC |
N | 103TF0200X | Forensic Psychologist | 3366 | NC |
N | 103TM1800X | Intellectual & Developmental Disabilities | 3366 | NC |
N | 103TP2701X | Group Psychotherapist | 3366 | NC |
N | 103TS0200X | School Psychologist | 3366 | NC |
NPI | 1023150562 |
---|---|
Provider Name | Dr. Patti M Zordich |
First Address | Cary, NC 27511-4566 |
Second Address | Cary, NC 27511-4566 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2007 |
Last Update Date | 15/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
6000983 | (02) | NC |