Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101Y00000X | Counselor | ||
N | 101YM0800X | Mental Health Counselor | ||
N | 101YP2500X | Professional Counselor | ||
Y | 102L00000X | Psychologist | ||
Y | 103T00000X | Psychologist | ||
N | 103G00000X | Clinical Psychologist | A0045 | MD |
N | 103TC0700X | Clinical Psychologist | A0045 | MD |
N | 103TC2200X | Clinical Child & Adolescent Psychologist | ||
N | 103TF0000X | Family Psychologist | ||
N | 103TM1800X | Intellectual & Developmental Disabilities | ||
N | 103TP2701X | Group Psychotherapist | ||
N | 103TR0400X | Rehabilitation Psychologist | ||
N | 103TS0200X | School Psychologist |
NPI | 1700339447 |
---|---|
Provider Name | Trawick Lindsay |
First Address | Largo, MD 20774-4783 |
Second Address | Largo, MD 20774-4783 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/07/2016 |
Last Update Date | 29/07/2016 |