Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1033399001 |
---|---|
Provider Name | Nicole Stokes |
First Address | Goodyear, AZ 85395-8376 |
Second Address | Litchfield Park, AZ 85340-4930 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/11/2007 |
Last Update Date | 07/11/2007 |