Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 4036960 | AZ |
NPI | 1023342706 |
---|---|
Provider Name | Ms. Sarah Elizabeth Gaines |
First Address | Tucson, AZ 85745-2326 |
Second Address | Tucson, AZ 85745-2326 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/09/2009 |
Last Update Date | 28/09/2009 |