Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | 35SI00157600 | NJ |
Y | 103TB0200X | Cognitive & Behavioral Psychologist | 20042356A | IN |
NPI | 1083644546 |
---|---|
Provider Name | Ronald M Westrate |
First Address | Wheat Ridge, CO 80033-2162 |
Second Address | Indianapolis, IN 46227-0962 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2006 |
Last Update Date | 18/08/2015 |