Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1396 | AZ |
Y | 103G00000X | Clinical Psychologist | 1396 | AZ |
Y | 103TC0700X | Clinical Psychologist | 1396 | AZ |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TP2701X | Group Psychotherapist |
NPI | 1003064908 |
---|---|
Provider Name | Jon Howard Mccaine |
First Address | Tucson, AZ 85713 |
Second Address | Tucson, AZ 85705-7714 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/09/2008 |
Last Update Date | 04/09/2008 |