Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | #0863 | NC |
N | 103TC1900X | Counseling Psychologist | #0863 | NC |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | #0863 | NC |
N | 103TM1800X | Intellectual & Developmental Disabilities | #0863 | NC |
NPI | 1063617983 |
---|---|
Provider Name | Mrs. Beth Causby Whitaker |
First Address | Morganton, NC 28655-9614 |
Second Address | Morganton, NC 28655-9614 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2007 |
Last Update Date | 08/07/2007 |