NPI | 1003026162 |
---|---|
Former Name | CHERYL ANNE WILSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: CA PSY 22053) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: HI 980) |
103TC0700X Psychologist, Clinical (Licence: FL PY5392) | |
Enumeration Date | 2007-05-23 |
Last Update Date | 2012-01-14 |