Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TS0200X | School Psychologist | 090122050 | CA |
Y | 103TS0200X | School Psychologist | 4193867 | AZ |
NPI | 1073745592 |
---|---|
Provider Name | Ms. Lauren Heather Richins |
First Address | Surprise, AZ 85374-7466 |
Second Address | Surprise, AZ 85374-7466 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/08/2009 |
Last Update Date | 17/08/2009 |