Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0700X | Adult Development & Aging Psychologist |
NPI | 1285391425 |
---|---|
Provider Name | Miss Bertina Patipy II |
First Address | Suitland, MD 20746-1332 |
Second Address | Suitland, MD 20746-1332 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2021 |
Last Update Date | 23/11/2021 |