Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | AZ |
NPI | 1093841066 |
---|---|
Provider Name | Mrs. Leanne Maree Coyne |
First Address | Phoenix, AZ 85086-8848 |
Second Address | Scottsdale, AZ 85262-5243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2007 |
Last Update Date | 26/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
882630 | (05) | AZ |