Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist |
NPI | 1104579234 |
---|---|
Provider Name | Sierra Fletcher |
First Address | Salisbury, MD 21804-3812 |
Second Address | Salisbury, MD 21804-3812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/01/2022 |
Last Update Date | 01/02/2022 |