Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 464313F | WA |
NPI | 1003169079 |
---|---|
Provider Name | Mrs. Golda Waugh |
First Address | Mount Vernon, WA 98273-4205 |
Second Address | Mount Vernon, WA 98273-4205 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2012 |
Last Update Date | 16/10/2012 |