Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1043889124 |
---|---|
Provider Name | Erin Mahaffey |
First Address | Yuma, AZ 85365-5561 |
Second Address | Yuma, AZ 85365-5561 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2021 |
Last Update Date | 22/06/2021 |