Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist | AZ |
NPI | 1023170453 |
---|---|
Provider Name | Sharon Marie Carpenter |
First Address | Cave Creek, AZ 85327-0426 |
Second Address | Scottsdale, AZ 85262-5243 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
580739 | (05) | AZ |