Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 35SI00443300 | NJ |
Y | 103T00000X | Psychologist | 35SI00443300 | NJ |
NPI | 1992999056 |
---|---|
Provider Name | Kristin M Briggs |
First Address | Bellmawr, NJ 08099-0635 |
Second Address | Stratford, NJ 08084-1354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2007 |
Last Update Date | 11/11/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0140856 | (05) | NJ |