Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | PSY1000907 | DC |
Y | 103G00000X | Clinical Psychologist | PSY1000907 | DC |
Y | 103TC0700X | Clinical Psychologist | PSY1000907 | DC |
N | 103TP2701X | Group Psychotherapist | PSY1000907 | DC |
NPI | 1013382928 |
---|---|
Provider Name | Mia Paustian |
First Address | Washington, DC 20007-2280 |
Second Address | Washington, DC 20007-2280 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2015 |
Last Update Date | 03/02/2021 |