Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 770 | KS |
N | 103T00000X | Psychologist | 770 | KS |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 770 | KS |
N | 103G00000X | Clinical Psychologist | 770 | KS |
N | 103TC0700X | Clinical Psychologist | 770 | KS |
N | 103TC1900X | Counseling Psychologist | 770 | KS |
NPI | 1013989458 |
---|---|
Provider Name | Mary Ann Abbott |
First Address | Topeka, KS 66606-2806 |
Second Address | Topeka, KS 66606-2806 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
R31106 | (02) | KS |