Organization Name: | LEN D MCCOY PSY D |
NPI Number: | 1215125562 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LEN DAVID MCCOY (OWNER) |
Mailing Address: | 1260 Se Bishop Blvd Suite B Pullman |
State: | WA US |
Postal Code: | 991635451 |
Phone Number: | 5093389100 |
Fax Number: | 5093380905 |
NPI Enumeration Date: | 10/11/2007 |
NPI Last Update Date: | 03/14/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PY00002727 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |