NPI | 1003054339 |
---|---|
Former Name | AMBER D. BAUER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103T00000X Psychologist (Licence: IL 071007604) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IL 071007604) |
Enumeration Date | 2009-01-23 |
Last Update Date | 2010-02-16 |