Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | $$$$$$$$$ | AZ |
NPI | 1043625841 |
---|---|
Provider Name | Meghan Sutherland |
First Address | Naperville, IL 60565-2882 |
Second Address | Naperville, IL 60565-2882 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2014 |
Last Update Date | 01/07/2014 |