Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
Y | 101YP1600X | Pastoral Counselor | ||
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0000X | Family Psychologist |
NPI | 1275072407 |
---|---|
Provider Name | Mr. Earl Newton I |
First Address | Phoenix, AZ 85043-1972 |
Second Address | Phoenix, AZ 85043-1972 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2017 |
Last Update Date | 21/02/2017 |