A licensed, doctoral-level psychologist authorized to prescribe and has undergone specialized education and training in preparation for prescriptive practice and has passed an examination accepted by the state board of psychology relevant to establishing competence for prescribing, and has received from the state board of psychology a current certificate granting prescriptive authority, which has not been revoked or suspended.
| Specialty | Taxonomy Code | |
|---|---|---|
| * | Prescribing (Medical) | 103TP0016X |
* Indicates primary specialty
| NPI Number | 1518108810 |
| Credentials | MD |
| Entity | Individual |
| Enumeration date | 03/16/2009 |
| Last updated | 03/16/2009 - About 17 years ago |
| Sole proprietor1 | Yes |
| Identifiers | n/a |
| Hospital affiliation | n/a |
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.
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