Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 103TC2200X | Psychologist | Clinical Child & Adolescent | | | No |
| 2 | 224Z00000X | Occupational Therapy Assistant | | | | No |
| 3 | 207Q00000X | Family Medicine | | | | No |
| 4 | 2080P0006X | Pediatrics | Developmental - Behavioral Pediatrics | | | No |
| 5 | 2080P0008X | Pediatrics | Neurodevelopmental Disabilities | | | No |
| 6 | 2084B0040X | Psychiatry & Neurology | Behavioral Neurology & Neuropsychiatry | | | No |
| 7 | 221700000X | Art Therapist | | | | No |
| 8 | 363A00000X | Physician Assistant | | | | No |
| 9 | 1835P0200X | Pharmacist | Pediatrics | | | No |
| 10 | 103TM1800X | Psychologist | Intellectual and Developmental Disabilities | | | No |
| 11 | 104100000X | Social Worker | | | | No |
| 12 | 106H00000X | Marriage & Family Therapist | | | | No |
| 13 | 133N00000X | Nutritionist | | | | No |
| 14 | 171M00000X | Case Manager/Care Coordinator | | | | No |
| 15 | 103K00000X | Behavior Analyst | | | | Yes |