Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TS0200X | School Psychologist | 404910B | WA |
Y | 1041C0700X | Clinical Social Worker | LW00007952 | WA |
NPI | 1053636852 |
---|---|
Provider Name | Dr. Theresa Lynn Mcdowell |
First Address | Cheney, WA 99004-1708 |
Second Address | Cheney, WA 99004-1708 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2010 |
Last Update Date | 05/04/2010 |