Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TC1900X | Counseling Psychologist | 0897 | KS |
NPI | 1023061835 |
---|---|
Provider Name | Dr. Paula L. Timmons |
First Address | Lawrence, KS 66049-4736 |
Second Address | Leavenworth, KS 66048-5014 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
060736 | BLUE CROSS BLUE SHIELD KS (01) | KS |