Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | NE |
NPI | 1043710320 |
---|---|
Provider Name | Jenny Pattee |
First Address | Hubbard, NE 68741-3084 |
Second Address | South Sioux City, NE 68776-3028 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2018 |
Last Update Date | 13/02/2018 |