Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 102L00000X | Psychologist | 1014 | WV |
N | 103T00000X | Psychologist | 1014 | WV |
N | 103TA0700X | Adult Development & Aging Psychologist | 1014 | WV |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1014 | WV |
Y | 103G00000X | Clinical Psychologist | 1014 | WV |
Y | 103TC0700X | Clinical Psychologist | 1014 | WV |
N | 103TC1900X | Counseling Psychologist | 1014 | WV |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | 1014 | WV |
N | 103TF0000X | Family Psychologist | 1014 | WV |
N | 103TP2701X | Group Psychotherapist | 1014 | WV |
NPI | 1134428469 |
---|---|
Provider Name | Mr. David Brandon Lawson |
First Address | Pineville, WV 24874-0274 |
Second Address | Pineville, WV 24874-0274 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2011 |
Last Update Date | 18/05/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3810019842 | (05) | WV |