Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1003301128 |
---|---|
Provider Name | Grace Mcintosh |
First Address | Nevada City, CA 95959-9017 |
Second Address | Nevada City, CA 95959-2218 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2018 |
Last Update Date | 30/06/2018 |