Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | 8616 | WV |
NPI | 1093119067 |
---|---|
Provider Name | Rebecca Jennings-Knotts |
First Address | Parkersburg, WV 26101-5855 |
Second Address | Ripley, WV 25271-1538 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/10/2014 |
Last Update Date | 20/10/2014 |