Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 36648 | MS |
N | 103TC1900X | Counseling Psychologist | 36648 | MS |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 36-648 | MS |
NPI | 1124127618 |
---|---|
Provider Name | Dr. Ruth W. Mcphearson |
First Address | Ocean Springs, MS 39564-3052 |
Second Address | Ocean Springs, MS 39564-3052 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00121264 | (05) | MS |