Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | PSY 16577 | CA |
Y | 102L00000X | Psychologist | PSY 16577 | CA |
Y | 103T00000X | Psychologist | PSY 16577 | CA |
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY 16577 | CA |
N | 103G00000X | Clinical Psychologist | PSY 16577 | CA |
N | 103TC0700X | Clinical Psychologist | PSY 16577 | CA |
N | 103TC1900X | Counseling Psychologist | PSY 16577 | CA |
N | 103TF0000X | Family Psychologist | PSY 16577 | CA |
N | 103TH0100X | Health Service | PSY 16577 | CA |
N | 103TP2701X | Group Psychotherapist | PSY 16577 | CA |
NPI | 1033139860 |
---|---|
Provider Name | Laurie L Windle |
First Address | Los Angeles, CA 90010-3101 |
Second Address | Los Angeles, CA 90010-3101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2006 |
Last Update Date | 25/11/2013 |