Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 3671100 | AZ |
NPI | 1093920365 |
---|---|
Provider Name | Lauren B Coe |
First Address | Peoria, AZ 85381-4624 |
Second Address | Peoria, AZ 85381-4624 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 08/07/2007 |