Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TS0200X | School Psychologist |
NPI | 1053890400 |
---|---|
Provider Name | William Roger Mccoy |
First Address | Santa Maria, CA 93454-9701 |
Second Address | Santa Maria, CA 93454-9701 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2018 |
Last Update Date | 07/08/2018 |