Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 396233R | WA |
NPI | 1003169921 |
---|---|
Provider Name | Mrs. Joslynne Rebecca Davidson |
First Address | Steilacoom, WA 98388-3304 |
Second Address | Steilacoom, WA 98388-3304 |
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 |