Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | PSY1000754 | DC |
Y | 103T00000X | Psychologist | PSY1000754 | DC |
NPI | 1013396514 |
---|---|
Provider Name | Ihori Kobayashi |
First Address | Washington, DC 20060-0001 |
Second Address | Washington, DC 20060-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2015 |
Last Update Date | 29/05/2015 |