Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 3806 | NC |
Y | 103T00000X | Psychologist | 3806 | NC |
N | 103TH0100X | Health Service | 3806 | NC |
NPI | 1134452204 |
---|---|
Provider Name | Genell N. Rashad |
First Address | Fayetteville, NC 28301-5401 |
Second Address | Fayetteville, NC 28301-5401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2009 |
Last Update Date | 08/09/2009 |