Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 499632H | WA |
NPI | 1023463486 |
---|---|
Provider Name | Melissa Huppin Korch |
First Address | Seattle, WA 98105-2305 |
Second Address | Seattle, WA 98105-2305 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2016 |
Last Update Date | 03/05/2016 |