Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | AZ |
NPI | 1003957325 |
---|---|
Provider Name | Ms. Lisa Sharon Coyner |
First Address | Tucson, AZ 85705-1547 |
Second Address | Tucson, AZ 85705-1547 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2007 |
Last Update Date | 26/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
920787 | (05) | AZ |